Since the federal guidance was issued, a few states have made voluntary changes to their policies. In April, New York voluntarily changed its policy upon the recommendation of its Drug Utilization Review Board. Just this week, Delaware announced that it will modify its coverage policies in order to avoid being sued. Earlier in the month, Florida announced that it is changing its policy to ensure that all Medicaid beneficiaries with Hepatitis C receive treatment. Florida health officials announced the changes after the National Health Law Program (NHeLP), Florida Legal Services and the Legal Aid Society of Palm Beach County successfully advocated on behalf of a Florida woman who had been repeatedly denied treatment, despite her worsening condition, because her Medicaid plan determined that treatment was not medically necessary. But as NHeLP and other organizations pointed out, federal law requires that Medicaid patients receive treatment for Hepatitis C promptly, not after they fall deathly ill. No patient, Medicaid enrollee or otherwise, should be forced to suffer and become sicker before receiving quality health care. These changes take important steps to ensure that Medicaid beneficiaries around the country have timely access to treatment that can cure their disease.
Denying Medicaid Patients Access to Hep C Treatments is Wrong and Illegal