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Pennsylvania HCV Medicaid Policy Removes Restrictions, State Announcement
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05/16/2017
Wolf Administration Announces Medicaid Policy Change for Individuals Suffering from Hepatitis C Virus
from Jules: apparently this change is due to an agreement by lawyersrepresenting Pennsylvania Medicaid recipients and the State. This press release from the State makes it sound like they should get credit for this, but does not mention the legal challenges brought to them by these Medicaid recipients denied access totreatment, so these determined Medicaid recipients & their determined lawyers deserve the credit. For years now HepCAP & Stacy Trooskin, MD & Alexandra Shirreffs joined this fight with the HCV community in Philadelphia. Finally, congratulations to the HCV+ community in Philadelphia & Pennsylvania. The reason State officials change link this is when they face a potential lawsuit they expect they will lose. This lawsuit was brought by affected Medicaid recipients, who are the ones who have the most success in challenging the States on this. A similar situation brought by denied Medicaid recipients in Florida helped as well. I think what this shows is that once you get intocourtif the case is brought properly judges recognize the legality of this situation - that the States are required to provide access to treatment to ALL, no restrictions, restrictions are legally forbid by federal law !!!! It is up to the States & the Federal government to fix this problem & come up with asolution but they have not. Ultimately Congress & the White House control these types of decisions. On a State level, state officials can negotiate deals too but they have not. The same problem still persists in most States throughout the USA. And there are no large scale State or Federal funded screening & linkage to care programs, because they do not want to spend the money!!!!!
http://www.media.pa.gov/Pages/DHS_details.aspx?newsid=258
Harrisburg, PA - Today, the Department of Human Services (DHS) is announcing changes to the state's Medicaid (MA) policy to expand coverage of life-saving drugs to treat Hepatitis C (HCV) virus. Beginning on July 1, the Department will begin phasing in coverage for individuals who have liver function test scores of "F1" or "F0".
HCV test scores are categorized by the severity of the disease from F0 through F4, with F0 being the least severe form of the disease and F4 being the most severe. Prior to this announcement, the department provided health care coverage through Medicaid for individuals whose scores ranged from F2 through F4 unless they also had other clinical complications.
"Today's announcement means that thousands of vulnerable Pennsylvanians will soon have easier access to pharmaceuticals that can cure HCV," said DHS Secretary Ted Dallas. "Moving forward, the severity of this disease can no longer prevent all MA beneficiaries from getting access to treatment if they need it."
The policy change follows the clinical recommendations presented by the department's Pharmacy & Therapeutics Committee.
Under the new policy, the department will authorize the drugs for beneficiaries with test scores of F1 starting on July 1, 2017 and will authorize treatment for beneficiaries with scores of F0 starting on January 1, 2018. Adding F0 and F1 will ensure that all qualified individuals with HCV will have access to pharmaceuticals that can now cure this disease.
HCV is a communicable disease that causes chronic inflammation throughout the body and can lead to serious liver damage, cancer, and death. At least 20,000 people in the United States die each year due to liver disease caused by HCV, making it the deadliest communicable disease in the country. Individuals with HCV can suffer from diabetes, lymphoma, fatigue, joint pain, depression, and other diseases even before reaching the advanced state of the disease.
"Pennsylvania's new approach will directly improve the lives of many of our clients – some of Pennsylvania's most vulnerable citizens," said Laval Miller Wilson, Executive Director of the Pennsylvania Health Law Project (PHLP).
"I would like to thank Laval, Amy Hirsch, Kevin Costello and everyone at PHLP, Community Legal Services, Kairys Rudovsky, Messing & Feinberg, and Center for Health Law & Policy Innovation of Harvard Law School who worked with the department on finding a path forward," said Secretary Dallas. "Their help has been invaluable throughout the process and been a critical component of being able to make today's announcement."
MEDIA CONTACT: Rachel Kostelac - 7174257606
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