AIDS Foundation of Chicago and Legal Council for Health Justice Statement on Medicaid Hepatitis C Treatment Restrictions
Legal Council for Health Justice and AIDS Foundation of Chicago (AFC) laud the Illinois Department of Health and Family Services (HFS) announcement today ending the department’s policy of rationing coverage of life-saving drugs to cure hepatitis C (HCV) for Medicaid participants.
As the deadliest infectious disease in the U.S., HCV affects an estimated 3.5 million Americans. Approximately 68,400 of those affected live in Illinois. Prior to the announced policy change, individuals enrolled in Medicaid were required to have severe liver damage before receiving coverage for treatment that would cure them of HCV. Additionally, some Medicaid participants were required to provide proof of sobriety for six months, a further barrier to access.
The expansion of the availability of hepatitis C therapy will have a great impact on the clients that we work with,” said infectious disease doctor Nancy Glick. “Removing the barriers to treatment will not only help the individual infected with HCV, it will have important public health implications for ending the epidemic for us all.”
Because 25 percent of people living with HIV in the U.S. also are infected with HCV, AFC is a strong advocate for the highest quality, most affordable and best access to HCV treatment possible. AFC has partnered with Legal Council during the past several months to help identify and recruit Illinois Medicaid participants for a federal class action lawsuit to challenge Illinois’ unlawful restrictions on coverage for the hepatitis C cure. On Oct. 11, 2018, attorneys from Legal Council, Jenner & Block, LLP, and the Center for Health Law and Policy Innovation at Harvard Law School, sent a formal demand letter to Illinois officials on behalf of those Illinois Medicaid participants, which resulted in the state changing policy for coverage of HCV medications.
“Finally, Illinoisans with hepatitis C will have no longer have to wait until they are near death with major, irreversible liver scarring before being eligible for the HCV cure under Medicaid,” said John Peller, AFC president/CEO. “With this disease affecting an estimated one in every 200 Illinois residents, many of them living with HIV, it was imperative that this policy be changed.”
The new policy makes a recognized hepatitis C cure—Direct Acting Antivirals, or DAAs—accessible for thousands of Illinoisans, many of whom were previously denied treatment until they reached end-stage disease.
“Illinois is taking positive steps to cure HCV, which is huge for the HIV community,” said Tom Yates, Legal Council Executive Director. “It’s just a matter of organizations working together to make change happen.”
Charlie Rice-Minoso, PCI