
Doe v. Managed Care Organization
Status: Victory
In the first legal ruling of its kind in the country, GLAD prevailed in an action to cover the cost of a life-saving liver transplant for a Medicaid recipient with both HIV and end-stage liver disease as a result of hepatitis C. The case was brought on behalf of a 41 year-old Roxbury, MA man who was in no danger of dying from his HIV, but would have died within months of Hepatitis-related liver disease without the transplant. Medicaid coverage was denied on the ground that liver transplants are “experimental” – and, therefore, are not covered – in the presence of HIV infection. On appeal, the Division of Medical Assistance Board of Hearings rejected the claim that liver transplantation is “experimental” in people with HIV. As a result of this decision, insurers cannot categorically exclude people with HIV from liver transplantation.
Related Content
-
Expanding Pharmacy Access to PrEP in Massachusetts
Read MoreThis life-saving legislation opens a new avenue to obtaining PrEP quickly and easily for people who have difficulty accessing health care.
-
MA Senate Passes Bill to Make PrEP Available at Pharmacies Without a Prescription
Read MoreThe life-saving legislation opens a new avenue to obtaining PrEP quickly and easily for people who have difficulty accessing health care in Massachusetts.
-
Removing Barriers to PrEP in Massachusetts
Read MorePrEP provides our best opportunity to end the HIV epidemic.