AHF Sues California Over Ending AIDS Health Plan

AHF filed a motion against the California Department of Health Care Services and its director, Michelle Baass, seeking a preliminary injunction preventing the state from ending a contract for AHF’s Positive Healthcare special needs program for people living with HIV/AIDS, while the cancellation is under appeal.

In late June, the state abruptly notified AHF it was not renewing its contract for 2023 for the 27-year-old specialty managed care plan, which AHF created and has successfully managed since 1995.

LOS ANGELES--(BUSINESS WIRE)--Hundreds of California’s HIV patients are slated to lose health care if the state pushes ahead with closing a 27-year-old managed care program at the end of 2022. To keep the program going, AHF has filed a motion in federal court seeking a preliminary injunction against California’s Department of Health Care Services (DHCS) and its director, Michelle Baass.

The injunction seeks to prevent the department from “… terminating, or refusing to amend or extend” AHF’s contract for its Positive Healthcare (PHC) special needs plan—the only specialized managed care plan for people living with AIDS in California—while the state’s cancellation of the contract is under formal appeal. The motion was filed today in United State District Court for the Central District of California (Case No. 2:22-CV-06636).

In late June, AHF received notice from state’s Department of Health Care Services (DHCS) that it was not renewing AHF’s contract for the plan for 2023, leaving patients at the mercy of other care plans whose medical providers don’t have the years-long relationships with these patients—and may also not have the same degree of expertise in managing the care of AIDS patients. Under the terms of the current contract, AHF is able to deliver a level of service that would not be available to patients if they are forced to leave the plan that has kept them alive and healthy for nearly three decades. AHF created and has successfully run the program on behalf of California’s Medicaid program since 1995.

The state alleged AHF improperly communicated with Positive Healthcare patients last fall when AHF sent a letter urging PHC enrollees to contact DHCS to advocate for the continuation of Positive Healthcare and the state’s renewal of AHF’s contract for the program, which was then set to sunset or end December 31, 2021.

Following the June DHCS notice of the contract cancellation, AHF filed a federal lawsuit asserting infringement of its (and PHC enrollees’ and members’) First Amendment rights over the state’s punitive action. AHF also filed a formal appeal of the contract cancellation with DHCS. However, Baass and DHCS intend to proceed with ending the contract by the end of the year. AHF asserts this will cause irreparable harm to both AHF and the patients it cares for in Positive Healthcare.

AIDS Healthcare Foundation (AHF), the largest global AIDS organization, currently provides medical care and/or services to over 1.6 million individuals in 45 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, follow us @aidshealthcare or subscribe to our AHF podcast “AHFter Hours.”