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Arizona Medicaid Told by Court to Cover Liver Transplant in HCV/HIV Coinfected Woman
  Woman with HIV wins case
Kerry Fehr-Snyder
The Arizona Republic
Oct. 31, 2005 12:00 AM
A Phoenix woman who is HIV-positive has won the right to receive a liver transplant paid for by taxpayers after an administrative law judge ruled that she couldn't be denied the life-saving treatment because of her health status.
Brenda Gwin, who was diagnosed with end-stage liver disease last November, was denied coverage that same month for a liver transplant by the state Medicaid program, the Arizona Health Care Cost Containment System, because of her HIV status. Lawyers with two free legal services filed a lawsuit on her behalf to overturn the decision.
The victory means that Gwin, 49, can begin the process of qualifying for a liver transplant through a national organ-donor network. Her liver disease was caused by hepatitis C. Her health has deteriorated, and she was unable to be interviewed for this story.
"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 Lambda Legal in New York City. The organization fights for the civil rights of lesbians, gay men, bisexuals, transgender people and those with HIV.
After an administrative law judge in Arizona sided with Gwin, AHCCCS officials agreed to pay for the transplant. But the agency hasn't changed a policy prohibiting members of its health plans with HIV from receiving organ transplants paid for by state Medicaid.
AHCCCS officials declined to comment but issued a statement saying it is considering revising its transplant policy for members with HIV. Previously, the agency argued that transplant recipients with HIV didn't fare as well as those without the virus. But Lambda lawyers cited a 2002 research article in the New England Journal of Medicine that found there is no evidence of poorer survival rates.
"The medical evidence overwhelming shows right now that people with HIV have just as good of a survival rate after a transplant as people without HIV," Sinton said. "It's potentially life saving for Brenda Gwin, and we believe it's a victory for other patients in the Arizona Medicaid system."
California recently passed a law that prevents insurers from denying organ transplants to members based on their HIV status. Veterans Affairs also must evaluate HIV patients for transplants on a case-by-case basis, according to a recent decision.
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