|(a) To ensure the program's expenditures do not exceed
the program's budget, the department will analyze the latest actuarial
projections for the upcoming year, including the average annual cost
per recipient and the projected number of recipients the program will
be able to serve using current budget figures.
(b) The department will perform this analysis of program
expenditures every quarter to determine if funds are sufficient to
meet projected expenditures.
(c) To make certain that expenditures do not exceed
the program's budget, the department may implement the following temporary
cost-containment measures as necessary.
(1) Cost-containment measures.
(A) Initiate medical criteria to meet at minimum the
most recent federal Department of Health and Human Services Guidelines
for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents,
which can be found at http://aidsinfo.nih.gov/Guidelines.
(B) Discontinue using the formula for adjusting the
applicant's gross annual income described in §98.109(b) of this
title (relating to Financial Eligibility Criteria).
(C) Lower the financial eligibility criteria described
in §98.109(a)(4) of this title to a level that is not lower than
125% of federal poverty level.
(D) Cease enrollment of new applicants.
(2) As funds become available, the department will
rescind the cost-containment measures in a manner which the department
judges most appropriate given the particular circumstances at that
(d) Cost-Containment measures, if implemented, will
be applied to recipients enrolling after the cost-containment measure(s)
|Source Note: The provisions of this §98.115 adopted to be effective August 28, 2003, 28 TexReg 6855; amended to be effective December 16, 2007, 32 TexReg 9128; amended to be effective November 20, 2013, 38 TexReg 8244