HIV-positive man appeals Medicaid denial of liver transplant

Attorneys for an HIV-positive man said in a hearing Wednesday that Pennsylvania's Medicaid program should cover his liver transplant because there is no evidence that otherwise healthy HIV-infected patients have a worse chance of organ transplant survival than those who are not HIV-infected. William Jean Gough was denied coverage by the state's Medicaid program for the transplant in August although transplant doctors deemed him medically eligible, and attorneys for Lambda Legal Defense and Education Fund and the AIDS Law Project of Pennsylvania are appealing the decision. Gough said he does not suffer from disabling HIV symptoms. Medicaid officials told Gough the state program could not cover his transplant because the surgery is experimental and not medically necessary. But at Wednesday's hearing, attorneys for the state argued the program cannot cover transplants for patients who have other life-threatening conditions. The judge isn't expected to rule in the case until December. In October, Kaiser Permanente, one of the largest U.S. health maintenance organizations, reversed an earlier decision and approved a kidney transplant for a HIV-infected Denver man. Gough believes appealing cases so that insurers cover transplants for HIV-infected patients are necessary steps in creating a better insurance system. "If I don't live long enough to receive a liver transplant, someone behind me will benefit from my actions, my fight," he said.