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Judge Upholds Right to HIV+Liver Transplant
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Judge Upholds Right to HIV+Liver Transplant
Judge Overturns Pennsylvania Medicaid Decision Not To Cover Liver Transplant for HIV+ Person
Altoona man wins ruling on liver transplant
By Charles Sheehan
Associated Press/ Philadelphia Inquirer, Dec 11, 2003
PITTSBURGH - An HIV-positive man in need of a lifesaving liver transplant was wrongly denied coverage under the state's Medicaid program, an administrative law judge has ruled.
William Jean Gough's liver is deteriorating due to hepatitis C. The 46-year-old from Altoona was accepted as a strong transplant candidate in August by Pittsburgh's Thomas E. Starzle Transplant Institute.
The state Department of Public Welfare, which oversees the state's Medicaid program, denied coverage for Gough, saying that HIV is a life-limiting condition that rules out a transplant.
In a ruling made public yesterday, Judge Bernadene Kennedy dismissed the state's argument, saying that scientific advances allow people with HIV to live full lives.
Kennedy expedited the case because Gough's condition worsens by the day and he could be ineligible for a transplant if his liver continues to deteriorate.
Doctors said Gough could die in nine to 12 months without a transplant. The average wait is six to 12 months.
"I've struggled with this disease for many years, and you've got to have hope," Gough said yesterday. "I just think it's a lack of education in our health-care system. It seems to me the state's working off of old criteria."
Gough tested positive for HIV and hepatitis C in 1996. A doctor submitted an affidavit stating Gough's HIV has been under control for years.
The Department of Public Welfare will not appeal the judge's ruling, spokeswoman Stephanie Suran said.
It is the second time in two months that Lambda Legal, a gay legal rights group, has successfully argued that patients with HIV should not be excluded from transplants just because they are HIV-positive.
In October, Kaiser Permanente, one of the nation's largest health maintenance organizations, approved a kidney transplant for an HIV-positive man in Denver, reversing an earlier decision.
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