Review of Ryan White Title II Funding in Florida

Florida did not always comply with Federal requirements in administering funds provided under Title II of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990. Title II grants fund the purchase of medications through the AIDS Drug Assistance Program (ADAP) and other health care and support services for people who have HIV/AIDS and who have no health insurance or are underinsured. For the period April 1, 2003, through March 31, 2006, Florida (1) did not fully comply with the requirement that Title II funds not be used to pay for drugs that are eligible for coverage by other Federal, State, or private health insurance and (2) did not always use Title II funds for clients whose files contained the documentation needed to determine eligibility for the ADAP. Based on our sample results, we estimated that Florida claimed $4.4 million in unallowable Federal funding.

We recommended that Florida (1) refund $4.4 million to the Federal Government; (2) follow its procedures for billing HIV/AIDS drugs to the Federal, State, or private health insurance plans with primary payment responsibility; and (3) follow its procedures for documenting clients' eligibility for ADAP funds. Florida said that refunding the money would have a devastating effect on ADAP clients but did not directly address our other recommendations. Florida did not provide any additional information that would cause us to modify our findings or recommendations.