Have you, or someone you know, on Medicaid in Colorado and have been denied treatment for hepatitis C because your fibrosis score was deemed too low? The ACLU wants to hear from you! Contact http://aclu-co.org/
The following is a letter from The American Civil Liberties Union of Colorado:
The American Civil Liberties Union of Colorado (ACLU) is considering legal action to challenge Colorado Medicaid’s policies that deny medically necessary care to Medicaid patients with Hepatitis C (HCV). It is our understanding that Colorado Medicaid will not authorize direct-acting antiviral (DAA) medications to treat HCV unless the patient has Stage 3 or Stage 4 hepatic fibrosis. This restriction, which the Center for Medicare and Medicaid Services implicitly criticized in a notice distributed to state Medicaid agencies last November, is inconsistent with treatment guidelines published by the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America.
We believe Colorado’s restrictive policies violate the Medicaid Act by denying medically necessary care. In other state, restrictive Medicaid policies are already bowing to legal pressure. In May, a federal district court in Seattle issued a preliminary injunction ordering the Washington Medicaid agency to provide DAA drugs to Hep C patients. The Indiana ACLU is litigating a similar challenge to similar state restrictions on availability of DAA medications. In response to demand letters from attorneys, the Medicaid agencies in Florida and Delaware very recently agreed to relax restrictions that are similar to Colorado’s restrictions.
In order to challenge the restrictions, we need to speak with patients who are adversely affected by them. We would like to talk with Medicaid patients who have a diagnosis of chronic HCV, but who cannot access DAA medications because of the unduly restrictive Colorado Medicaid policies. Specifically, patients with HCV who whose doctors have prescribed or want to prescribe DAA medications for HCV, but who cannot get those medications because the patient did not have an F3 or F4 fibrosis score.