Arizona Cannot Deny Medicaid Coverage of Liver Transplant for HIV-Positive Woman, Judge Says

An administrative law judge in Arizona has ruled that an HIV-positive woman cannot be denied Medicaid coverage for a liver transplant, the Arizona Republic reports. Brenda Gwin was diagnosed with end-stage liver disease in November 2004 and the state Medicaid program denied her coverage that month for a liver transplant. The agency argued that HIV-positive transplant recipients do not fare as well as HIV-negative recipients. Lawyers with two legal services sued on Gwin's behalf to overturn the decision. Gwin now can begin the process of qualifying for a liver transplant through a national organ-donor network. "This represents another example of the shift toward recognizing that organ transplantation should not be denied based on HIV status alone," Jen Sinton, a lawyer with the Lamda Legal Defense and Education Fund, said (Fehr-Snyder, Arizona Republic, 10/31). Attitudes about organ transplants for HIV-positive people have been changing since the mid-1990s, when advances in antiretroviral drug therapy began to help HIV/AIDS patients live longer, healthier lives. Antiretroviral treatment can restore patients' immune systems enough to allow them to withstand transplants and the immune-suppressing drugs that prevent the rejection of new organs (Kaiser Daily HIV/AIDS Report, 4/29/04). The Arizona Health Care Cost Containment System, the state's Medicaid program, has agreed to pay for the transplant, but it has not altered its policy excluding HIV-positive beneficiaries from receiving Medicaid coverage for organ transplants. The agency's officials refused to comment on the case but released a statement saying AHCCCS is considering a change in its transplant policy for HIV-positive beneficiaries (AP/Advocate, 10/31).