The purpose of this Management Memorandum is to notify PrEP-AP Enrollment Workers and PrEP-AP Clinical Providers of an option for clients to utilize the self-reported OraQuick In-Home HIV test result to substantiate PrEP-AP eligibility. With client consultation with their clinical provider, PrEP-AP is temporarily allowing use of the OraQuick In-Home HIV test for clinical monitoring. The California Department of Public Health’s, Office of AIDS, AIDS Drug Assistance Program (ADAP) in coordination with Magellan Rx Management is temporarily approving the use of OraQuick In-Home HIV testing kits to minimize PrEP-AP client’s exposure to COVID-19.
PrEP-AP clients are required to provide one of the following to establish their negative HIV status and the document must be dated within 6 months of the PrEP-AP application:
- Negative HIV lab results
- Copy of Patient Assistance Program approval letter from Gilead (uninsured clients only)
- Gilead Patient Assistance Program Application signed by a PrEP-AP Network Provider (uninsured clients only)
- PrEP-AP Provider Referral Form signed by a PrEP-AP Network Provider (uninsured clients only)
PrEP-AP will allow clients to self-report negative results of an OraQuick In-Home HIV Test to substantiate their negative HIV status. Clients already enrolled in PrEP-AP can also utilize an OraQuick In-Home HIV Test if their healthcare provider recommends against in-person lab testing due to the COVID-19 pandemic. PrEP-AP will cover costs for an OraQuick In-Home HIV Test that is dispensed through pharmacies in the Magellan Rx network as long as the client has active eligibility.
Guidance for Clients
PrEP-AP clients may obtain an OraQuick In-Home HIV Test kit in person at a pharmacy within the Magellan Rx network (if available), or by calling participating mail-order pharmacies within the Magellan Rx network. Clients should contact their pharmacy within the Magellan Rx network to confirm availability of the OraQuick In-Home HIV Test kit prior to visiting the pharmacy. Mailing of OraQuick test kits is at the discretion of the dispensing pharmacy. To find out more information regarding mail order pharmacies who will mail OraQuick In-Home HIV test, please visit https://cdph.magellanrx.com/
. The list will be updated periodically as pharmacies agree to participate. Clients will need to inform the pharmacy that they are enrolled in PrEP-AP and present their Magellan Rx benefit card when requesting that the OraQuick In-Home HIV Test be paid for by PrEP-AP. Results of the tests may be reported directly to the client’s healthcare provider via a telemedicine appointment, electronic patient portal, or by phone. It is recommended that clients discuss the advantages and disadvantages of in-home testing with their healthcare provider. In certain situations (e.g., recent HIV exposure or symptoms consistent with acute HIV infection), a healthcare provider may strongly recommend in-person HIV testing with a blood sample as testing oral fluid for an antibody is not as sensitive as testing a blood sample. Documenting results of an in-home HIV test in a client’s medical record is also recommended. A photograph of the results may be accepted as proof of as negative HIV status to enroll into PrEP-AP. In order to reduce the risk of a possible privacy incident, enrollment workers should send the client an encrypted e-mail that the client can respond to in order to provide the test result. This policy will remain in place until further notice.
In order to notify the network pharmacies of this additional benefit and the billing instructions, Magellan has sent a fax blast to all the pharmacies within its network to inform the pharmacies how to correctly bill for OraQuick In-Home HIV testing kits dispensed to PrEP-AP clients. PrEP-AP will cover the cost for an OraQuick In-Home HIV Test that is dispensed through pharmacies in the Magellan Rx network and the client should not be charged at the time of service.
If you have any questions regarding the contents of this Management Memorandum, please email the PrEP-AP inbox at PrEPSupport@cdph.ca.gov
Sandra Robinson, MBA
ADAP Branch Chief
California Department of Public Health