Washington state investigators modeled 5-year costs and virologic suppression outcomes of changing from a 6- to a 12-month ADAP recertification schedule, to help inform policy decisions on the feasibility and effect of implementing new recertification timings.  Key outcomes included: (a) projected cost of the Washington State ADAP, (b) number of people virologically suppressed, and (c) number of people who received services while ineligible for ADAP.  The model was stratified by health insurance type (public, private, or none) and receipt of case management services; 2017-2019 enrollment data informed transition probabilities.  Data on the monthly cost of ADAP services by health insurance type and case management status were obtained from the state Department of Health administrative database.  Under a continued 6-month recertification criteria, the model estimated ADAP would enroll 4,727 clients/month at a per-client cost of $7,966 (at the end of the 5-year period, 6,834 clients would be virologically suppressed and total program cost was estimated at $37,663,000).  With a 12-month recertification, ADAP would enroll 5,331 clients/month at a per-client cost of $7,543 (at the end of the 5-year period, 7,079 clients would be virologically suppressed and total cost was estimated at $40,217,000).  Under the 12-month scenario, 245 more people would be virologically suppressed by the end of 2025.  The $423 reduction in cost/client corresponded to a ~5% lower administrative cost.