Archive for Wednesday, May 4, 2011

Kansas Court of Appeals sides with Jehovah’s Witness in Medicaid dispute over liver transplant

May 4, 2011


— The Kansas Court of Appeals on Wednesday ruled that a state agency violated the constitutional rights of a Jehovah's Witness when it denied authorization for her to travel to a different state to have a liver transplant paid for by Kansas Medicaid funds.

Mary Stinemetz, 64, of Hill City has end-stage liver disease and needs a transplant. But her religion forbids whole blood transfusions, and there are no hospitals in Kansas that perform bloodless transplants.

The Kansas Health Policy Authority denied authorization for Stinemetz to have such a transplant in Nebraska and have it paid for by the Kansas Medicaid fund. A lawyer for KHPA said it didn't deny permission because of the woman's religious beliefs, but because of the distance from Kansas where the procedure would be performed.

The appeals court said that's not a good enough reason to deny her request.

"The available evidence indicates that the bloodless technique is less expensive than a procedure involving blood transfusions," Judge Thomas Malone wrote in the three-judge panel's unanimous ruling. "The available evidence indicates that a bloodless liver transplant is a medically accepted technique offered by several medical facilities in other states, including the Nebraska Medical Center and at the University of Oklahoma."

Despite the court's ruling, there's no guarantee Stinemetz will be able to have the surgery. Her attorney, Corinne Petrik, told The Associated Press on Wednesday that Stinemetz couldn't even apply to become a candidate for the transplant until she had authorization from Kansas for the operation.

"She's pretty happy about it," Petrik said of her client's reaction to the court ruling. "We're hoping she'll still be a candidate for the surgery. The longer you wait, the more ill you become, and that kind of effects whether you're a viable candidate."

Petrik said Stinemetz has been told it will take two to three weeks to schedule an evaluation at the Nebraska hospital. If she's deemed to be a good candidate for a transplant, she'll be put on a waiting list.

KHPA attorney Brian Vazquez last month told the appeals court that if the bloodless procedure would have been available in Kansas, it would have been covered by Medicaid. In its ruling, the court noted that Stinemetz's request for out-of-state services was denied on the grounds that "her religious preference did not constitute a medical necessity."

Since Kansas Medicaid regulations allow KHPA to make exceptions to the rule about out-of-state procedures, the court said, KHPA was wrong to deny the woman's religious hardship exemption.

"Here, the KHPA has failed to suggest any state interest, much less compelling interest, for denying Stinemetz's request for prior authorization for the out-of-state liver transplant," Malone wrote.

The court reversed a district county court's ruling siding with KHPA and directed the agency to grant Stinemetz's request for the operation.


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