Discrimination based on a patient’s HIV status could cost you.
 
Winston C. San Agustin, M.D., a neurological surgeon in Monterey Park, Calif., examined a man with HIV who had back and hip pain, according to a decision and order from HHS’ Departmental Appeals Board (PDF). San Agustin diagnosed spondylolisthesis and recommended a laminectomy, then scheduled the surgery.
 
Once his secretary told him that the patient was HIV positive, the doctor had a meeting with the patient, confirmed the HIV status and then refused to perform the surgery, suggesting that the patient go to the county hospital for treatment, the decision states. San Agustin specifically mentioned the patient’s HIV status in his correspondence discharging the patient from the practice.
 
As readers of Medical Practice Compliance Alert know, discharging a patient because of a disability violates the Rehabilitation Act of 1973.
 
The Office for Civil Rights details the attempts to settle with San Agustin, but his “lack of cooperation establishes that he will not voluntarily comply with the Act ...,” the order states. So terminating his Medicaid funding is “an appropriate remedy.”
 
“His receipt of federal financial assistance shall be terminated until such time as he demonstrates that he will comply with the requirements of the Act and regulations,” according to the decision.