HIVMA Board Chair Michael Saag, MD submitted recommendations regarding the new Pre-existing Condition Insurance Program to ensure people with HIV can fully benefit from the program.
Key recommendations included:
Requiring the federal and state-operated PCIP to contract with Ryan White funded medical providers to ensure continuity of care for people with HIV disease.
Classifying HIV disease as a “presumed eligible” disease group within the definition of “pre-existing condition” and not requiring individuals to demonstrate that they have been denied coverage on the basis of their HIV status in order to qualify for PCIP coverage. Many of our patients with HIV disease have been uninsured for longer than six months but are able to receive some services through the Ryan White program. Requiring these patients to apply for health coverage for which they will be denied is counterproductive and will only delay access to the program.
Including HIV disease as a qualifying condition for eligibility in all states regardless of whether the program is operated by the state or the federal government to ensure equitable access to coverage across the U.S.
Facilitating wrap around coverage by Ryan White in states that are equipped do so.
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