Massachusetts Panel Rules Against Liver Transplant for HIV-Positive Patient
A panel of transplant specialists convened by the Massachusetts Office of Patient Protection decided yesterday after five days of deliberation that a liver transplant for a patient infected with HIV and hepatitis C is an "experimental procedure with unproven effectiveness" and therefore HMO coverage of the procedure is not required, the Boston Globe reports. Although a liver transplant is a "routine surgical procedure," state HMO Neighborhood Health Plan said that it did not violate its contract when it denied coverage to Belynda Dunn, because the case was "complicated by her HIV status." Dunn's attorney said that the panel's decision is not binding, and he will take the case back to U.S. District Court, which forwarded it to the state panel earlier this week (Gedan, Boston Globe, 7/20). Another federal hearing of Dunn's case is scheduled for July 26. The Office of Patient Protection enlists expert panels to determine the merits of patient coverage appeals, and the Center for Health Dispute Resolution in Pittsford, N.Y., "rounded up" the panel to review Dunn's case. Her case is the first life-and-death decision issued by the seven-month-old panel (Macero, Boston Herald, 7/20).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.