AIDS Law Project of Pennsylvania

AIDS Law Project of Pennsylvania seeks to hire a Housing Law Attorney to expand its housing practice. To learn more about this opportunity and how to apply, please visit: https://www.aidslawpa.org/about-a/employment-opportunities/

Justice Timed: Home care hours restored for double amputee Mary is a 56-year-old double amputee living with HIV. More than a decade ago, she was injured in a fall, and an infection spread to both of her legs. Double amputation was the only way to get the infection under control. For many years, Medicaid paid for her in-home care, eight hours a day, seven days a week. In January 2019, a managed care company took over her Medicaid services. Her ongoing care needs were schedul...ed to be reviewed every six months. The review included an in-home assessment. No changes were recommended in the first four reviews. The trouble started in November 2020, when the reviewer called and said he was sick and didn’t want to come to her house because of COVID concerns. Instead of rescheduling the appointment, the review was submitted without the in-home assessment. The managed care company claimed she refused the in-home assessment and cut her home care hours in half. Mary filed a grievance. Fearful about how she would manage without full-time assistance, she asked her doctor for help. He told her to call us. Knowing that Mary desperately needs uninterrupted care, we advocated with the managed care company. We requested that her hours not be cut, while we appealed the decision. In the end, we were able to settle the matter with the managed care company’s legal department, and Mary’s benefits were restored. Despite her struggles, Mary can continue to live in her own home.

Justice Affirmed: Medicare reimburses client for gender-affirming surgery Our client, Sara, a 52-year-old trans woman from Central Pennsylvania living with HIV, knew she needed surgery to affirm her gender identity. Her medical team in Philadelphia knew she needed it. But would Medicare cover this necessary service?... Knowing from experience that the struggle for Medicare payment would be long and complicated, the surgical team suggested that Sara pay for it and then seek reimbursement from Medicare. Sara turned to her family for financial assistance. They knew she had suffered all her life from gender dysphoria, and they offered to pay for the surgery. After her surgery was completed, Sara felt secure enough to request that Medicare reimburse her. But Medicare denied her request, claiming the surgery was cosmetic and therefore not a covered service. The AIDS Law Project of Pennsylvania had helped Sara with many issues over the years. So she turned to us for help when Medicare denied her claim. We filed an appeal arguing that her history and medical documentation established that the gender-affirming surgery was reasonable and necessary. Medicare denied the appeal, claiming that Sara’s documentation did not detail her gender dysphoria diagnosis. We appealed again and requested a hearing before an Administrative Law Judge. This month, the judge issued a decision without the need for a hearing. The judge specifically found that the gender reassignment surgery services were not for cosmetic purposes, but a part of a comprehensive, medically necessary treatment plan for gender dysphoria. Sara felt vindicated that Medicare finally recognized that her surgery was necessary and that it was a covered service.

Sending wishes for a happy birthday, a merry Christmas and a healthy and happy new year to my dear partner, Yolanda French Lollis. Together we have guided the AIDS Law Project of Pennsylvania for more than 25 years.

On this Veterans Day, we salute AIDS Law Project clients who bravely served our nation. You had our backs and we have yours.

Last Sunday, the AIDS Law Project did this to support people living with HIV and our friends at AIDS Walk Philly.

Be a lifeline on Sunday, October 18, 2020. You still have time to support the cause! Donate, Tune in and walk around your neighborhood, make sure to send your pictures to [email protected]. You can also join Team 0008 by sponsoring someone from the AIDS Law Project of Pennsylvania. ... http://www.aidswalkphilly.org/profile/team/0008/

In Memoriam: Mark A. Davis (1956-2020) The AIDS Law Project of Pennsylvania mourns the passing of our longtime friend Mark A. Davis, 64, who died Sept. 14. Mark lived half his life with HIV. In fact, his email signature announced that he had tested positive 32 years ago on Sept. 27, 1988.... Mark was well-known as an advocate for people struggling with mental health and addiction. He was a champion of the LGBTQ community and those living with HIV. He was the founding president of the Pennsylvania Mental Health Consumers’ Association and founded Pink & Blues, a support group for sexual and gender minority individuals who also have lived experience with a mental health diagnosis. Seven years ago, Mark excitedly joined our excursion to Atlantic City to see the Miss America Pageant, even bringing his own tiara and sash. RIP, Miss Altered States.

For the inside story of how the ADA almost fell apart over the inclusion of people with HIV, tune in today at 2 p.m. https://zoom.us/webinar/register/WN_JqlkgM7UTJyJhK9Sw0WWQA