Caring for HIV Patients in California

"If it's true that a society is judged by how it cares for the elderly, the sick and the poor, the state's reputation for charity and compassion will be greatly impaired if a health care bill for HIV patients dies on the governor's desk. That's where AB937 has languished since leaving the floor of the Legislature on Sept. 13. Gov. Gray Davis has until Oct. 14 to sign the measure, which aims to guarantee reasonable care for HIV patients by providing reasonable pay for the doctors who treat them. "We receive more and more complaints from HIV patients and skilled HIV specialists about the lack of timely access, referrals and low reimbursement rates that nearly have bankrupted the limited number of California physicians who continue to treat HIV/AIDS patients," said author Assemblyman Paul Koretz (D-West Hollywood).

"Among other things, the bill would require HMOs to reimburse HIV specialists at a rates that doesn't restrict patient's access to care. The bill would also require Medi-Cal to develop risk-adjusted rates for HIV treatment similar to the one it has for AIDS care.

"As is, most HMOs use a 'capitation' scheme to pay doctors about $80 a month per HIV patient to cover the cost of specialists, emergency room and hospital care, and sometimes prescription drugs. Consequently, patients often go without care because fewer and fewer doctors can afford to serve them.

"Predictably, the insurance lobby opposing the bill has been loud and strong, vehemently rejecting any option requiring the industry to increase payments. But AB937 is a no-nonsense, life-and-death measure of both our humanity and our commitment to fight this dreaded disease. Davis should sign the measure, which cleared both houses of the Legislature by wide margins."

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