Arizona Health Care Cost Containment System Must Cover Transplant for HIV-Positive Woman
October 31, 2005
An administrative law judge has ruled that an HIV-positive Phoenix woman cannot be denied a state Medicaid-funded liver transplant on the basis of her health status.
Last November, Brenda Gwin was diagnosed with end-stage liver disease caused by hepatitis C infection. That same month, the Arizona Health Care Cost Containment System (AHCCCS) denied Gwin Medicaid coverage for a liver transplant because of her HIV status. Attorneys with two free legal services filed a lawsuit on her behalf to overturn the AHCCCS decision.
"This represents another example of the shift toward recognizing that organ transplantation should not be denied based on HIV status alone," said Jen Sinton, a lawyer with New York City-based Lambda Legal, one of the groups that worked on Gwin's case.
The victory means that Gwin can now start the process of qualifying for a liver transplant through a national organ-donor network.
While AHCCCS officials have agreed to pay for the transplant, the agency has not changed the policy barring HIV-positive members of its health plans from receiving Medicaid-funded organ transplants. AHCCCS officials declined to comment on the ruling but said the agency is considering revising its transplant policy for members with HIV.
AHCCCS has previously argued that HIV-positive transplant patients did not fare as well as those without the virus. But Lambda lawyers cited a 2002 New England Journal of Medicine report that found no evidence of poorer survival rates for HIV-positive organ recipients.
"The medical evidence overwhelmingly shows right now that people with HIV have just as good of a survival rate after a transplant as people without HIV," said Sinton. "It's potentially life saving for Brenda Gwin, and we believe it's a victory for other patients in the Arizona Medicaid system."
Arizona Republic (Phoenix)
10.31.05; Kerry Fehr-Snyder
This article was provided by U.S. Centers for Disease Control and Prevention. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update. Visit the CDC's website to find out more about their activities, publications and services.