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ALBANY — The state Attorney General has reached an agreement with CDPHP over its coverage of hepatitis C treatments, ending a lawsuit filed last month that accused the Albany-based health insurer of breaking the law by delaying coverage until patients were in advanced stages of the disease.
Under the terms of the agreement, Capital District Physicians’ Health Plan will no longer restrict coverage of some hepatitis C treatments to only those patients with severe symptoms, such as scarred livers. The insurer also agreed to cease denying coverage based on patients’ alcohol or drug use and to allow treatment authorized by any appropriately trained provider, not just liver specialists.
The insurer will also pay $25,000 in legal fees and must provide notice of the policy changes to existing members who previously were denied coverage for treatment of the liver disease.
The agreement comes on the heels of settlements reached by Attorney General Eric Schneiderman’s office with seven other private insurers, including Schenectady-based MVP Health Care and the parent of Latham-based BlueShield of Northeastern New York, following an investigation that determined they were inappropriately delaying or otherwise restricting coverage for hepatitis C treatment.”With today’s settlement, my office has now reached agreements with every private health insurance plan in New York that was previously denying certain forms of coverage for Hepatitis C,” Schneiderman said. “This is a victory for public health and for patients across the state.”
Read more…http://www.timesunion.com/local/article/AG-settles-with-CDPHP-over-hep-C-coverage-7652896.php