(a) To request an application packet, call toll-free
1-800-255-1090 or write to: Department of State Health Services, HIV/STD
Prevention and Care Branch, Texas HIV State Pharmacy Assistance Program,
Attn: MSJA, Mail Code 1873, P.O. Box 149347, Austin, Texas 78714-3947.
(b) Submit completed application, along with accompanying
documentation and certification forms, to: Department of State Health
Services, HIV/STD Prevention and Care Branch, Texas HIV State Pharmacy
Assistance Program, Attn: MSJA, Mail Code 1873, P.O. Box 149347, Austin,
Texas 78714-3947.
(c) The applicant is expected to give informed consent
to the department so that the program may contact a medical provider,
Medicare, or Medicare prescription drug plan to verify information
contained in the application and/or to request additional supporting
documentation pertaining to the application.


Source Note: The provisions of this §98.8 adopted to be effective December 16, 2007, 32 TexReg 9127; amended to be effective November 20, 2013, 38 TexReg 8244