BUSINESS WIRE; Tuesday December 23, 6:06 pm EST
"This settlement guarantees the viability of our innovative AIDS managed care program," said Michael Weinstein, president of AIDS Healthcare Foundation. "Not only has the state agreed to pay funds owed, but terms for future payment of services have been settled," he said.
AHF operates Positive Healthcare, the nation's first and largest managed care program tailored to meet the specific needs of persons with AIDS. Through a state contract, AHF provides all necessary medical treatment to Positive Healthcare enrollees for a fixed monthly rate, rather than through a traditional "fee-for-service" mechanism.
The program has achieved its chief objectives, which include creating enhanced medical services to persons with AIDS while controlling taxpayer costs. Enrollment has continued to grow, and the program is designated by the federal government as a special project of national significance.
The future of the program had been jeopardized, however, by the state's refusal to share savings generated by the program -- despite contractual obligation to do so. "The state had agreed in writing that our success in generating savings would mean increased funds for our medical services," said Weinstein.
"Unfortunately, the state's refusal to honor the 'savings share' terms meant any savings solely benefited the state, to the detriment of our patient services." AHF is the nation's largest community-based medical provider to the uninsured infected with HIV. Despite 2-1/2 years of operation, the state had refused to pay any share savings to AHF.
The foundation initiated a lawsuit in state and federal court, which resulted in the out-of-court settlement. In addition to settling funds owed, the agreement set terms for future savings sharing through the end of 1999.
"This is terrific news for our program," said Weinstein. "Positive Healthcare is planning expansion, and this action allows us to do so on firm financial footing."
For more information on this issue, contact Cesar Portillo, AHF government affairs director, at 213/860-5202; or Jessie Gruttadauria, AHF government affairs manager, 213/860-5203, or Ged Kenslea, AHF community relations director 213/860-5225 pager 213/209-8123.
AHF serves more than 5,000 Greater Los Angeles patients regardless of their ability to pay at four outpatient and two residential facilities; the WomensCare Center; through Positive Healthcare; AHF's Research Division, and through AHF's Treatment=Life Division featuring the WEHO Lounge, the nation's first coffeehouse/HIV testing and information center.
Contact: AIDS Healthcare Foundation, Los Angeles Ged Kenslea, 213/860-5225 Anthony Schulte, 213/860-5224
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Copyright © 1997 - Business Wire. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Business Wire, Permissions Desk, Business Wire, 1185 Avenue of the Americas, 3rd Floor, New York, NY 10036; Tel: (212) 575-8822; FAX: (212) 575-1854. http://www.businesswire.com.
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