New Mexico HIV patient challenges Medicare drug denial

Federal lawsuit challenges denial of antinausea medication for HIV-positive woman.

BY Matthew Van Atta

April 07 2006 11:00 PM ET

An HIV-positive
women in Albuquerque has filed a federal lawsuit against
several U.S. officials in an effort to get the new Medicare
prescription drug plan to cover the antinausea
medication her doctors say keeps her alive, The
Albuquerque Journal
reports. Catherine E. DeBonet
filed suit against Centers for Medicare and Medicaid
Services administrator Mark McClellan, Health and
Human Services secretary Michael Leavitt, and
UnitedHealth Group, which handles DeBonet’s Medicare
coverage. UnitedHealth denied DeBonet’s request
for the antinausea drug Zofran because the Food and
Drug Administration has approved it for use only 12
times monthly and DeBonet’s doctors say she needs to
take it three times per day. The high dosage of the
drug is the only way to treat nausea caused by her
antiretroviral drug therapy; without the Zofran, DeBonet is
unable to eat at all, her doctors have told UnitedHealth.

DeBonet’s
lawsuit says that without the Zofran she will required to
have a permanent feeding tube inserted into her body,
which will raise her risk of pain, infection, and
possibly even serious complications.

The New York Times reported in February that many HIV
patients around the country are having problems with
the new Medicare drug benefit. Cumbersome
preauthorization requirements and piles of paperwork
for doctors have resulted in delays or even the prevention
of access to needed medications. Some participating
programs can have as many as 30 preauthorization forms
for certain drugs. (The Advocate)

Tags: Health

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