• DSHS HIV/STD Program

    Post Office Box 149347, MC 1873
    Austin, Texas 78714

    Phone: 737-255-4300

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MAC Meeting Minutes November 20, 2015

Texas HIV Medication Advisory Committee Meeting
November 20, 2015

The November 20, 2015 meeting of the Texas HIV Medication Advisory Committee (MAC) was held at 4110 Guadalupe Street, West Auditorium, Building 582 in Austin, Texas.

MAC Members in Attendance: Philip Keiser, M.D., Chair, Natalie Vanek, M.D., Vice-Chair, MaryPaul, M.D., Fernando Garcia, M.D., Raul Castaneda, R.Ph., Yolanda Rodriguez-Escobar, David Huse, Frank Rosas, Bruce Turner

DSHS Staff in Attendance: Janna Zumbrun, Felipe Rocha, Shelley Lucas, Lisa Cornelius, M.D., Rachel Sanor, John Allen, Becky Ruiz, Juliet Garcia, Janina Vasquez, Justin Irving, Laura Potter, Lester Mattson, R.Ph.

Registered Guests: Steve Nettles, Jesse Jones, Tom Valentine, Suzanne Erickson, Sunnye Simmons, Michelle Puyear, Tyler Hunter, Karin Petties, Becky Gonzales, Brandon Wollerson, Alexandra Zingg, Victoria Ford, Mark Vance, Mary Helen Gloria, Allen Murray, Isis Torrente, Alex C. Moses, Eunice Marshall, Kalvin Marshall, Tana Pradia, Barry Kountz, Rodney Mills, Denis Kelly, Venita Ray, Holly Turner, Armando Chavez, Chris Tubbs, JayDee Fredricksen

Action and Discussion Items Covered:

  1. The meeting was called to order by Dr. Keiser at 12:35 pm, November 20, 2015.

  2. The committee reviewed and unanimously approved the July 17, 2015 meeting minutes.

  3. Janna Zumbrun provided an update on the Division for Disease Control and Prevention and the selection of the new DSHS Commissioner, Dr. John Hellerstedt effective January 1, 2016. Ms. Zumbrun gave assurance that the Medication Advisory Committee would remain intact during the transitions taking place within HHSC based on the Sunset Committee report.

  4. Felipe Rocha, Manager of the TB/HIV/STD/Viral Hepatitis Unit, presented an update on the THMP Budget and a snapshot of current ADAP projections.

  5. Rachel Sanor presented ADAP/SPAP update reports detailing first time enrollment by month and program, clients served by month and over the past four quarters, monthly medication order costs over the past four quarters, clients served by EMA during the last half of Fiscal Year (FY) 2015, medication order costs by EMA for the last half of FY 2015, the top ten drug prescription expenditures the last half of FY 2015, comparison graphs of ADAP clients and persons living with HIV in Texas by sex and by race, ADAP client demographics for FY 2015 by gender, by race and by age group, and HMS findings on outcomes for insured clients.

  6. Dr. Keiser and Shelley Lucas led a discussion regarding Hepatitis C Virus (HCV) coinfections amongst the HIV population in Texas and the potential for adding HCV medications to the ADAP formulary in a manner that meets the mission guidelines given to ADAPs per HRSA and the Ryan White Care Act. Motions were approved to table the discussion for now and for additional review to be performed by DSHS for presentation at the next MAC meeting.

  7. The committee discussed adding Daraprim to the THMP formulary, and a motion was unanimously approved to recommend doing do. Representatives from Turing Pharmaceuticals gave assurances to the MAC and DSHS staff that the current distribution method for Daraprim would be adjusted to meet THMP procedures, with Amerisource setting up third-party distribution through contracted wholesaler Morris & Dickson for drop shipments.

  8. Rachel Sanor updated the committee on the ongoing process of Part B Modified Adjusted Gross Income (MAGI) implementation throughout the state.

  9. Rachel Sanor updated the committee on findings for THMP third-party health insurance verification conducted through the agreement with HMS (Health Management Systems). The first data match report in January 2015 flagged 1,500 THMP recipients for review by THMP staff. About 800 patients were ultimately dropped from the program due to insurance plans that needed to be utilized; from those originally dropped, 11% had their THMP enrollment reinstated with proof the plans had been terminated and 4% more were enrolled in to the TIAP or SPAP programs as appropriate. Currently 46% of the clients are under current review for coverage determination, with their ability to order THMP medications on hold while staff determines current eligibility for coverage. Ms. Sanor explained that the administrative agencies are notified each month that persons within their coverage area are being dropped for insurance. She also stated that HRSA is very pleased to see this system being implemented by Texas as part of the payer of last resort requirements.

  10. Shelley Lucas presented information on the KPMG audit recommendations, explaining how thoroughly the auditors scrutinize program policies, procedures and processes. She gave the example of how strongly the auditors recommend the collection of primary source documentation such as tax transcripts versus personal copies of tax returns, which the auditors equate to self-attestation of income. The THMP staff have to ensure the program is in compliance with recommendations set forth by HRSA, the Office of Inspector General, and designated auditors for the State of Texas and the Ryan White Grant.

  11. The next MAC meeting was tentatively scheduled for Friday, March 4, 2016.

  12. There were no public comments.

  13. The meeting was adjourned by Dr. Keiser at 3:03 pm.

Approved by:
Phillip H. Keiser, M.D. – Chairman, Texas HIV Medication Advisory Committee

Last updated June 11, 2020