Neighborhood Health Plan Donates $100,000 for AIDS Activist’s Liver Transplant After Refusing to Cover Procedure
Although the Massachusetts HMO Neighborhood Health Plan has twice rejected an appeal by a member infected with HIV and hepatitis C to cover her liver transplant, the company announced on Friday that it will donate $100,000 to help pay for the $250,000 "life-saving surgery," the Boston Globe reports. A "Life Fund" established for patient Belynda Dunn "came seemingly out of nowhere," but thanks to the HMO and fundraising efforts by Boston Mayor Thomas Menino, the fund now stands at $325,000, with a $50,000 contribution from Neighborhood Health Plan-affiliate Harvard Pilgrim and $175,000 from anonymous donors. The HMO's donation does not signal a change in its policy against covering the costs of liver transplants for HIV-positive patients, as it deems the procedure "experimental" for these patients, the Globe reports. HMO Medical Director Dr. Paul Mendis said that it would be at least three years before transplants for HIV-positive members would be covered (Gedan, Boston Globe, 7/21). Dunn had taken her case to U.S. District Court, but the court forwarded it on to the state Office of Patient Protection. On Thursday, a panel of transplant specialists convened by the state office ruled that a liver transplant for a patient infected with HIV is an "experimental procedure with unproven effectiveness" and therefore HMO coverage of the procedure is not required (Kaiser Daily HIV/AIDS Report, 7/20). Neighborhood Health Plan CEO John Hooley explained that by denying coverage to Dunn, the company, which has a reputation for serving HIV-positive patients, found itself in an "uncomfortable" and "ironic" position and sought a way to help. The Life Fund was the creation of Boston Public Health Commissioner John Auerbach and Massachusetts Public Health Commissioner Howard Koh. Auerbach's office will hold a fund planning meeting today. Dunn will receive the surgery at the University of Pittsburgh Medical Center, which has performed transplants on patients with HIV in the past. Only 25 patients with HIV and hepatitis C have received liver transplants worldwide, but survival rates are similar to patients without HIV, about 70% after one year (Lawrence, Boston Herald, 7/21).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.