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Insurers agree to accept premiums for HIV patients while judge considers suit

Tuesday, February 25, 2014
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Updated: 3 p.m. CST

BATON ROUGE, La. — A federal judge received assurances Tuesday that three insurance companies won’t immediately stop accepting premium payments from a program that helps HIV and AIDS patients cover health care costs.

After receiving the pledge that no payments would be rejected before April 1, U.S. District Judge Brian Jackson lifted the temporary restraining order he had issued only hours earlier prohibiting the dropped coverage.

U.S. District Judge Brian Jackson

U.S. District Judge Brian Jackson

Jackson plans a March 10 hearing on whether to issue a long-term injunction that would bar the companies from refusing to accept payments from the Ryan White HIV/AIDS program, which helps more than 2,400 low- and moderate-income Louisianians pay for health coverage.

Lambda Legal, an HIV/AIDS advocacy group, filed a lawsuit against Blue Cross and Blue Shield of Louisiana, the Louisiana Health Cooperative and Vantage Health Plan because of the companies’ plans to stop accepting the third-party payments.

They are the only companies widely offering insurance coverage across Louisiana through the online marketplace created under the federal health care law.

Blue Cross announced earlier this month that it planned on March 1 to stop accepting payments from unrelated third parties for an individual, citing fraud concerns. The other companies had said they planned to follow the lead of Louisiana’s largest health insurer.

In a hearing Tuesday, Richard Tyler, a lawyer for Blue Cross, said the company had pushed back the plans and would continue taking premium payments from outside parties like the Ryan White fund until April 1.

Lawyers for the Louisiana Health Cooperative and Vantage said they are continuing to accept third-party payments for coverage, and they committed to Jackson that the policy wouldn’t change before April.

With those commitments, Jackson then agreed to remove the restraining order.

“I’m satisfied that no injury will be suffered, if you will, by the plaintiff and putative class, at least at this time,” Jackson said.

The judge warned that if any of the companies try to stop coverage for a person with HIV or AIDS covered with Ryan White program funds, he’d reinstitute the restraining order and consider sanctions.

The lawsuit was filed on behalf of John East, who has Blue Cross insurance coverage with premiums paid by the Ryan White program. He received notification that Blue Cross was going to stop accepting such payments and said he can’t afford the $1,306 monthly premium on his own.

People living with HIV and AIDS accuse the companies of discrimination, saying it appears designed to keep costly patients from insurance programs and to get around language in federal law that prohibits insurers from denying coverage based on pre-existing conditions.

Blue Cross denies a discriminatory intent, saying the prohibition will help ensure that people aren’t being steered by a third-party payer to a specific product or health provider, to combat attempts to defraud the system. The company notes the change will cover all individual members, regardless of their health status or type of plan.

Advocacy groups for people with HIV and AIDS say people with Ryan White funds are the largest population that uses third-party payments to cover insurance premium costs.

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