XPost: ba.politics, dc.media, soc.penpals   
   XPost: alt.burningman   
   From: linusr@splc.org   
      
   Low-income HIV patients in Louisiana are finding themselves left   
   in the dark after all three insurance companies that handle   
   coverage under the Affordable Care Act across the state said   
   they’d start rejecting certain federal assistance.   
      
   Earlier this month, a Reuters exclusive claimed that hundreds of   
   people with HIV/AIDS in the Bayou State were about to be cut off   
   from coverage because the largest insurance carrier there, Blue   
   Cross and Blue Shield of Louisiana, said it would stop accepting   
   third-party payments like those made possible by a 24-year-old   
   law that earmarks millions of dollars in assistance annually to   
   people living with HIV/AIDS.   
      
   “The carrier says it no longer will accept third-party payments,   
   such as those under the 1990 Ryan White Act, which many people   
   with HIV/AIDS use to pay their premiums,” the newswire reported   
   then.   
      
   But according to a follow-up by Reuters published last Thursday,   
   smaller insurance carriers across Louisiana are following suit,   
   and customers are finding that the federal funds they once   
   relied on for medicine and treatment might soon disappear.   
      
   In addition to Blue Cross and Blue Shield of Louisiana,   
   Louisiana Health Cooperative and Vantage Health Plan — two   
   smaller insurers — now say they will reject third-party   
   payments. Together, the three companies make up the entirety of   
   those in Louisiana that sell coverage to residents under the   
   Affordable Care Act, United States President Barack Obama’s   
   hallmark healthcare legislation often called “Obamacare.”   
   Humana, a fourth company, will for now accept payments made   
   through the HIV/AIDS assistance program, but only offers   
   coverage through the Obamacare marketplace in the Orleans Perish   
   region of the state.   
      
   Ted Griggs, a journalist for The Advocate, estimates that close   
   to 2,000 impoverished Louisiana residents living with HIV/AIDS   
   will be impacted by the maneuver.   
      
   Ahead of the official Obamacare roll-out last October, the   
   Centers for Medicare and Medicaid Services (CMS) — the lead   
   government agency involved in the program — told insurers that   
   Ryan White funds "may be used to cover the cost of private   
   health insurance premiums, deductibles and co-payments" for   
   patients enrolled in Obamacare, according to Reuters. By   
   November, however, the CMS was warning "hospitals, other   
   healthcare providers and other commercial entities" that it has   
   "significant concerns" about what the newswire regarded as   
   “supporting premium payments and helping Obamacare consumers pay   
   deductibles and other costs, citing the risk of fraud.”   
      
   Sure enough, a spokesperson for Blue Cross Blue Shield cited   
   fraud to Reuters a few weeks ago when explaining the insurer’s   
   decision.   
      
   "As an anti-fraud measure, Blue Cross and Blue Shield of   
   Louisiana has implemented a policy, across our individual health   
   insurance market, of not accepting premium payments from any   
   third parties who are not related" to the subscriber, Blue Cross   
   Blue Shield of Louisiana spokesman John Maginnis said.   
      
   Both Maginnis’ remark and the warning from CMS come despite a   
   statement on the website for the US Department of Health and   
   Human Service’s Health Resource and Service Administration in   
   which the Affordable Care Act is hailed as “an historic   
   opportunity for people living with HIV (PLWH), including those   
   currently receiving services through the Ryan White Program, to   
   increase their access to affordable, quality health care.”   
      
   Maginnis told The Advocate that “organizations can still provide   
   the members with financial support toward their premiums, but   
   they must let the members make the premium payments directly for   
   their health insurance policies.” Such a transaction, however,   
   is forbidden under the rules established by the federal Health   
   Resources and Services Administration, which oversees the Ryan   
   White program — named for an American teenager who died of   
   complications from AIDS in 1990.   
      
   “In no case may Ryan White HIV/AIDS Program funds be used to   
   make direct payments of cash to recipients of services,” The   
   Advocate quoted from the agency’s website in a report published   
   to their website last week.   
      
   Lambda Legal, a non-profit group that advocates on behalf of HIV   
   patients, filed a federal civil rights complaint against Blue   
   Cross Blue Shield of Louisiana’s decision shortly after it was   
   announced. It has since filed separate complaints against   
   Louisiana Health Cooperative and Vantage Health Plan, Reuters   
   reported, in an effort to force insurers to accept third-party   
   payments made by federal assistance programs.   
      
   "The worst nightmare for people with HIV/AIDS is coming true in   
   Louisiana: they're being turned away in what's become a race to   
   the bottom by insurers,” Susan Sommer, the group’s director of   
   constitutional litigation, said to Reuters.   
      
   "What we're seeing in Louisiana is a crisis for low-income   
   people with AIDS," she said. "These are exactly the people the   
   Affordable Care Act was designed to provide a safety net for."   
      
   According to the advocacy coordinator at Shreveport, LA’s   
   Philadelphia Center, Eric Evans, prescriptions for HIV patients   
   can cost as much as $10,000 a month. He now tells The Advocate   
   that Lambda Legal is considering filing lawsuits against the   
   three insurer carriers if the federal complaints don’t cause the   
   companies to reconsider.   
      
   In the meantime, Louisiana Blue reiterated just last week that   
   it will stop accepting third-party payments for premiums   
   beginning at the start of next month. That new policy, the   
   company told Reuters, is “a safeguard against ... patient   
   steering and other fraudulent activities."   
      
   According to the newswire, the CMS said this week that it "is   
   considering amending the rules to require," and not merely   
   allow, "issuers to accept these (Ryan White) payments."   
      
   http://rt.com/usa/health-coverage-aids-louisiana-607/   
      
       
      
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