Federal Agency Refuses To Approve Norfolk, Va., Contract With Local Pharmacy To Provide AIDS Drugs Under Ryan White CARE Act

The Health Resources and Services Administration, the federal agency that oversees Ryan White CARE Act funds, has refused to approve the city of Norfolk, Va.'s contract with a local pharmacy to provide antiretroviral drugs to HIV-positive individuals who are eligible for the Ryan White program, the Virginian-Pilot reports. Bayview Plaza Pharmacy is the only pharmacy in the Norfolk area that serves individuals in the Ryan White program; however, HRSA will not approve the city's contract with the pharmacy because the agency says Bayview "charges too much," according to the Virginian-Pilot. Bayview has been filling prescriptions for individuals with HIV/AIDS "on good faith" since July, the Virginian-Pilot reports. Norfolk officials have tried to get the contract approved since July and set an Oct. 10 deadline for approval. When the contract was not approved, Norfolk officials told Bayview to stop filling prescriptions, and the city will now have to pay the pharmacy the $100,000 that it is owed for filling earlier prescriptions, according to the Virginian-Pilot. "The city is left holding the bag," Nada Kawwass, an assistant city attorney, said. HRSA spokesperson Kevin Ropp said that his agency has "to be responsible to use taxpayer funds as best we can," adding that HRSA is "trying to work with Norfolk to provide the medications necessary at a reasonable cost." HIV-positive individuals in the Ryan White program can still access antiretroviral drugs through the state's AIDS Drug Assistance Program; however, program participants will not be able to obtain other medicines such as pain relievers and antidepressants that would be covered by Ryan White funds. Kawwass said that the city is still in negotiations with HRSA and has been "trying to find out what will make them approve the contract."

Past Criticism
Norfolk officials have been "sharply criticized" for their management of Ryan White funds, the Virginian-Pilot reports (Szabo, Virginian-Pilot, 10/17). A contract dispute between Norfolk officials and clinic doctors regarding billing practices earlier this year resulted in the revocation of the clinics' Ryan White funds. Eastern Virginia Medical School clinics used a billing method in which doctors receive a set fee for each patient, a practice that is reportedly not allowed under federal government regulations. As a result, the clinics, which are the primary source of HIV/AIDS care for 1,200 of the area's uninsured and underinsured patients, had to cease operations. In addition, city administrators have failed to spend almost $1 million a year in Ryan White funding, even though many eligible HIV-positive people did not receive treatment. Currently, the Ryan White funds are administered by a program director in the city manager's office; however, the city plans to turn over management of the funds to the Planning Council, a private, not-for-profit human services provider (Kaiser Daily HIV/AIDS Report, 10/14).