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A new lawsuit seeks to force state Medicaid officials to revoke a policy limiting high-priced drugs to treat hepatitis C to only the sickest patients. After a similar suit last month, a private insurer changed its policy.
Two weeks after suing private insurers for improperly denying costly drugs to patients with hepatitis C infections, Seattle lawyers have expanded the fight to Washington state’s Medicaid provider.
A class-action lawsuit filed this week on behalf of two Apple Health clients — and nearly 28,000 others with the liver-damaging disease — seeks to force the Health Care Authority (HCA) to change a policy that limits the spendy drugs to only the sickest patients.
Two Medicaid patients, a 53-year-old Seattle woman and a 47-year-old Lakewood man, were prescribed the drug Harvoni to cure their hepatitis C infections. However, the prescriptions were denied because the drug is too expensive, according to the complaint filed in U.S. District Court in Western Washington.
“It is unlawful to withhold prescription drugs that cure a disease from Medicaid beneficiaries based on the cost of those drugs,” the complaint filed by the firm Sirianni, Youtz, Spoonemore and Hamburger states. Co-filers include Columbia Legal Services and the Center for Health Law and Policy Innovation at Harvard Law School.