Feb 11, 2014 7:52 PM by Akeam Ashford

Patients With HIV/AIDS Could Have Hard Time Finding Healthcare Coverage

Advocates for HIV and AIDS patients are furious over a controversial decision by the state's largest healthcare provider.

According to a recent policy change by Blue Cross Blue Shield of Louisiana (BCBS), HIV and AIDS patients could have a harder time paying for treatment.

In a statement released by BCBS spokesperson John Maginnis, the company says "Our policy is that effective March 1, 2014, we will only accept individual members' premium payments from the policyholder or an immediate family member/blood relative or legal guardian of the policyholder. We will no longer accept third-party payments."

This policy change comes after the Centers for Medicare and Medicaid (CMS) issued an advisory to insurance companies, warning about potential fraud.

Maginnis said the company is reviewing the latest information from CMS who's rules do not prevent use of Ryan White funds.

"We are reviewing and considering this new information to decide whether it is helpful in addressing our concerns about taking third-party payments," wrote Maginnis in an email.

The Ryan White program issues grants to help patients pay for treatments they otherwise might not be able to afford.

In 2012, Louisiana received more than $50 million dollars in grant funding from this program.

Claude Martin is the CEO of Acadiana C.A.R.E.S., a Lafayette based organization that helps patients with HIV and AIDS. Martin thinks Blue Cross' decision could cost more in the long run. "To be able to be assured of their healthcare is economically a big savings for the state too. If we wait and let people get so sick that they need to have catastrophic kind of care; that's more expensive and who's going to pay for it," Martin said.

Maginnis added, "While health privacy concerns prevent me from giving specific examples, it is not correct that patients with HIV/AIDS using federal funds to pay for healthcare are the only group affected. While most of our individual members already pay their own premiums or have an immediate family member or legal guardian pay it for them (for example, parents will pay for their child's premium), we do have a limited number of individual members who have paid for their premiums through third-party payments. And, these members' premiums are not all paid through the same third party."  Employers are still allowed to pay for benefits as well.

Martin says there are still options out there for any HIV/AIDs patients. He suggests reaching out to health care providers or to the local AIDS resource group for guidance.



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