Gwin v. Arizona Health Care Cost Containment System

Case arguing against state Medicaid program that denied HIV-positive woman a life-saving organ transplant.

  • Status: Closed
    • Opened: 09/30/05
    • Closed: 10/25/05
  • Attorneys
    • Co-counsel/Cooperating Attorneys: Srini Varadarajan (Community Legal Services, Inc.)

Summary

Brenda Gwin was diagnosed with end-stage liver disease as a result of Hepatitis C.  Her condition was deteriorating rapidly and her doctors determined that she met the criteria for and needed a liver transplant.  Mercy Care, one of the providers within the Arizona Health Care Cost Containment System ("AHCCCS" — Arizona's Medicaid program), informed Gwin's doctor that the request for coverage had been turned down because she was HIV-positive. AHCCCS claimed that its policy denied those infected with the HIV-virus from state-financed organ transplants because they considered the treatment experimental.  Lambda Legal filed a lawsuit on behalf of Gwin arguing that people with HIV should be evaluated on a case-by-case basis like any other transplant candidates. The judge agreed. As a result of his decision, Mercy Care agreed to pay for Gwin's transplant.  After advocacy by Lambda Legal, working with the Arizona Center for Disability Law, AHCCCS made some modifications to its policies and we are continuing to advocate for additional improvements to those policies. 

Context

Both the federal Rehabilitation Act and Americans with Disabilities Act protect people with disabilities, including HIV, from discrimination by physicians. Yet, even in cases where a transplant is medically necessary and life saving, HIV-positive people are often denied and blocked from consideration for transplants.

Lambda Legal's Impact

Following the ruling, AHCCCS agreed to use state-funds to pay for Gwin's liver transplant, and stated that they would be re-examining their regulations regarding people with HIV/AIDS with a view of amending their procedures.  This is one of many Lambda Legal cases to ensure that people with HIV have fair and equal access to medical care and other key services.

History

  • June 2005 Gwin is denied a liver transplant.
  • September 2005 Lambda Legal files a lawsuit on Gwin's behalf.
  • October 2005 Arizona’s Medicaid program abides by the administrative law judge’s ruling and agrees to pay for Gwin’s transplant.