Florida changes hepatitis C drug policy for Medicaid

The change comes after three organizations sued in April, warning that the Florida Agency for Health Care Administration’s policies violate patient rights under the Medicaid Act. Previously, hepatitis C patients were only given the medication when they were at a so-called fibrosis level three or four. Patients often have such severe liver damage in stage four that they require a transplant, said Vicki Tucci Krusel, an attorney with Legal Aid Society of Palm Beach County.

“But everyone who’s F zero, one and two was not getting the medication, so the state was basically waiting until someone gets really sick instead of getting someone the medication they need to get better now. Under the amended criteria, the fibrosis level is no longer a requirement,” said Krusel, who filed the suit along with Florida Legal Services and the National Health Law Program. “The policy change will ensure the health of Medicaid recipients statewide. I hope other states follow Florida’s lead.”

The change went into effect Wednesday. Florida health officials said they would give the insurance companies that administer Medicaid program until June 17 to make the changes and noted plans could still review cases to prove that patients aren’t using drugs or are seeking

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