Summaries of health policy coverage from major news organizations
HIV-Positive Activist Denied Health Insurance Coverage for Liver Transplant Undergoes Procedure
Belynda Dunn, an HIV- and hepatitis C-positive Massachusetts AIDS activist who lost her bid to have her health insurance cover a liver transplant last summer, underwent the procedure on Tuesday at the University of Pittsburgh Medical Center, the Boston Globe reports (Dembner, Boston Globe, 3/7). Chris Viveiros, a spokesperson for AIDS Action of Massachusetts, where Dunn works, said she is expected to remain in Pittsburgh for several weeks, adding, "We're very optimistic and very happy Belynda got her surgery. It will be great when she's back here in the office" (Associated Press, 3/6). Dunn had initially requested the liver transplant last March, but Neighborhood Health Plan denied coverage, and its internal appeals board rejected two subsequent requests. NHP said that it would not cover the surgery because liver transplants for people with HIV are considered "experimental" and such surgeries are not covered under the HMO contract Dunn had signed. The Gay and Lesbian Advocates and Defenders filed suit against the health plan on Dunn's behalf, but the Massachusetts Office of Patient Protection upheld NHP's decision to reject coverage for Dunn's transplant. Meanwhile, Boston Mayor Thomas Menino created a fund to raise money to pay for Dunn's operation (Kaiser Daily HIV/AIDS Report, 7/26/01). However, after a state Medicaid appeals board approved coverage of a liver transplant for a different HIV-positive patient, NHP reversed its decision, saying it would cover any costs above the $240,000 raised by Menino's fund. The plan also contributed $100,000 to the mayor's fund, the Globe reports. The two transplant cases have prompted the state Department of Public Health to develop guidelines to assist health insurers and health care workers in making decisions regarding which transplants should be considered experimental and which should be considered standard care. "I'm hopeful that this will be a nationally recognized effort," Public Health Commissioner Howard Koh said (Boston Globe, 3/7).
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