Florida Judge Rules for AHF in Medicaid Contract Case Involving Health Coverage of Thousands with HIV
AIDS Healthcare Foundation (AHF), the nation’s largest non-profit HIV/AIDS healthcare provider and largest global AIDS organization, today claimed vindication after a Florida Administrative Law Judge ruled in favor of AHF in a legal action over the denial of the renewal of a contract involving health coverage for thousands of the state’s Medicaid HIV patients.
AHF filed the lawsuit against Florida’s Agency for Health Care Administration (AHCA) and others last spring for their failure to renew an HIV care contract with AHF’s Positive Healthcare — a respected non-profit which has been providing critical health insurance coverage for people living with HIV in Florida since 1999.
Earlier this week, State of Florida, Division of Administrative Hearings’ Judge John D.C. Newton, II, issued a Recommended Order in the case upholding the majority of AHF’s legal contentions involving the state’s denial of the renewal of an HIV care contract with Positive Healthcare. In its lawsuit—and numerous protests, community actions and advocacy ads seeking to persuade state officials to overturn their decision to deny the contract renewal—AHF asserted that the state’s action would recklessly disrupt care for a vulnerable population of nearly 2,000 Florida HIV patients.
“Vindication! The order issued by Judge Newton in our case against Florida’s Agency for Health Care Administration and others upholds our contentions over the denial of the renewal of the HIV care contract with Positive Healthcare. All of this—the uncertainty for Florida Medicaid patients living with HIV, the protests, the legal action—could have been avoided had AHCA done the right thing to start,” said Michael Weinstein, President of AHF. “This was first and foremost an extreme disservice to vulnerable HIV patients, taking away their choice to select between a mission driven nonprofit like AHF’s Positive Healthcare and profit-driven private insurers. We thank Judge Newton for looking out for the best interest of patients and urge the state not to spend any more money appealing this case. We also look forward to sitting down now with state officials to hammer out an agreement.”
“The decision by Florida Medicaid officials not to renew the contract for HIV care with Positive Healthcare was simply shortsighted. Many of these patients have been seeing their doctor for years, even decades, and are thriving in care. If their care is jobbed out by huge, for-profit insurance companies for treatment by a family medicine doctor or general practitioner without HIV expertise, it would undoubtedly disrupt patient care for thousands of Floridians living with HIV,” said Donna Stidham, Chief of Managed Care for AHF. “When we received word yesterday that Florida Administrative Law Judge Newton ruled in our favor and rejected all the bids for HIV Specialty plans in Region 10 (Broward) and Regions 11 (Miami-Dade and Monroe), we saw this as a victory for what it truly is: a victory for the patients we serve.”
The judge's decision in his Recommended Order now goes to AHCA who must accept or reject the judge's decision.
HIV/AIDS in Florida
“HIV remains a complex disease that affects all aspects of a patient's health and is best managed by primary care HIV specialists who see the patient’s whole medical history and drug profile and work together with the patient to ensure his or her optimal care,” said Dr. Michael Wohlfeiler, AHF’s Chief of Medicine/US. “AHF’s Positive Healthcare plan is equipped to help the patient navigate the many challenges these patients face. Many of these patients also often suffer from stigma and discrimination, making it difficult for them to seek out and establish trust with a new medical provider and his or her clinic staff. We thank Judge Newton for his ruling in this matter.”
“The reality is that Florida is the epicenter of the HIV epidemic in the United States today, and people living with HIV should have the right to choose where they receive their HIV care,” said Mike Kahane, AHF Bureau Chief, Southern Region. “AHF is a highly respected non-profit organization devoted to serving the needs of the patient. AHF’s Positive Healthcare also provides a voice to people living with HIV. And unlike most large insurance providers like Aetna and United Health, it provides wraparound services, including access to our AHF healthcare centers where expert HIV medical care is provided, as well as access to our AHF Pharmacies, all staffed with teams solely dedicated to helping patients overcome barriers to care.”
- Nearly 5,000 people in Florida were infected with HIV in 2016 alone, which means one out of every eight new HIV infections in the United States occurred in Florida.
- South Florida leads the nation in new HIV diagnoses at 38.7 new infections per every 100,000 people. In contrast, the overall rate in the United States is 12.3 new infections per every 100,000 people.
- Nearly 136,000 Floridians are estimated to be living with HIV, but one in six is still not aware of his or her HIV-positive status.
- More than 30,000 Floridians currently living with HIV are not receiving care for their infection.
AIDS Healthcare Foundation (AHF), the largest global AIDS organization, currently provides medical care and/or services to over 1,000,000 individuals in 42 countries worldwide in the US, Africa, Latin America/Caribbean, the Asia/Pacific Region and Eastern Europe. To learn more about AHF, please visit our website: www.aidshealth.org, find us on Facebook: www.facebook.com/aidshealth and follow us on Twitter: @aidshealthcare and Instagram: @aidshealthcare
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