Pennsylvania Medicaid ordered to pay for liver transplant

By Advocate.com Editors

Originally published on Advocate.com December 13 2003 12:00 AM ET

An administrative law judge in Pennsylvania this week ruled that the state's Medicaid program must pay for a liver transplant for an HIV-positive man the program earlier ruled was ineligible for the surgery, the Pittsburgh Post-Gazette reports. Doctors had determined that William Gough of Altoona, Pa., was a qualified candidate for the surgery because the antiretroviral drugs he takes has kept his HIV infection in check. But Medicaid officials said the surgery was considered experimental for someone with a compromised immune system and rejected his application for the transplant surgery. Gough is also coinfected with hepatitis C, which has damaged his liver. "We're very pleased," said Hayley Gorenburg, AIDS project director at Lambda Legal Defense and Education Fund, which along with the AIDS Law Project of Pennsylvania represented Gough. "According to the judge's decision, [Gough] can expect Medicaid will finance the transplant if he can get a suitable match." Officials with the state's Medicaid office said they would not challenge the decision.