The Wisconsin AIDS Drug Assistance Program (ADAP) provides access to life-saving anti-retroviral medications and other medications used in the treatment of HIV to eligible low-income Wisconsin residents who are uninsured or under-insured.

ADAP is supported by federal Ryan White funds, state funds, and rebates from pharmaceutical companies. ADAP reimburses pharmacies for ADAP formulary medications at the Wisconsin Medicaid rate and professional dispensing fee in effect on the date of service.

ADAP is the payer of last resort, and pharmacy providers are required to bill all other payers before billing ADAP.

Currently Medicaid-enrolled pharmacy providers, including out-of-state pharmacy providers, who provide ADAP services are required to re-enroll as ADAP providers via the ADAP Provider Enrollment Application in order to submit and adjust claims and receive reimbursement for services covered by ADAP.

Providers are required to promptly notify ForwardHealth of any changes to their demographic information. ForwardHealth strongly encourages providers enrolled in ADAP to update their demographic information using the demographic maintenance tool.

If providers enrolled in ADAP are unable to update their information online, they can complete and mail the Provider File Update Request form, F-00916 (12/13), to ForwardHealth. Alternate versions of this form will not be accepted and will be returned to providers.

If demographic information changes, providers enrolled in multiple programs (for example, Wisconsin Medicaid and ADAP) are required to update the demographic information for each program. By toggling between accounts using the Switch Organization function of the Portal, providers who have a Portal account for each program may change their information for each program using the demographic maintenance tool. The Account User Guide provides specific information about switching organizations.

Providers licensed or certified by the Division of Quality Assurance (DQA) are required to notify the DQA of changes to physical address, changes in ownership, and facility closures by calling 608-266-8481. Providers do not need to notify ForwardHealth because the DQA will inform ForwardHealth of the changes.

Contact Provider Services with questions regarding the ADAP provider enrollment application. Contact the ADAP Coordinator at 800-991-5532 with questions about ADAP billing, policy, and member enrollment.

For additional information, refer to the ForwardHealth Update (2012-60), titled "Implementation of ForwardHealth interChange for the Wisconsin AIDS/HIV Drug Assistance Program."