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TITLE 25HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 98TEXAS HIV MEDICATION PROGRAM
SUBCHAPTER CTEXAS HIV MEDICATION PROGRAM
DIVISION 1GENERAL PROVISIONS
RULE §98.115Fiscal Planning

(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 time.

(d) Cost-Containment measures, if implemented, will be applied to recipients enrolling after the cost-containment measure(s) is implemented.


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

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