On November 5, 2015, Wall Street Journal released “Federal Officials Warn States on Hepatitis C Drug Restrictions” about the federal government’s strong warning to states with Medicaid programs that have placed unreasonable restrictions to accessing the Hepatitis C (HCV) cure. The article by Joseph Walker reviews the guideline Notice released by the Centers for Medicare & Medicaid Services (CMS).
Excerpt from article:
“The Centers for Medicare and Medicaid Services said in a notice to state Medicaid directors that some states may be ‘imposing conditions for coverage that may unreasonably restrict access’ to hepatitis C drugs. Such restrictions may be ‘contrary to the statutory requirements’ of a federal law requiring Medicaid programs to pay for all medically necessary treatments, defined as any use approved by the Food and Drug Administration or by certain medical guidelines known as compendia, the notice said.”
“Patient advocates praised CMS’s guidance to states, which they said would help increase the availability of treatments for patients. Robert Greenwald, director of Harvard University’s Center for Health Law and Policy Innovation, said in an email that his group ‘applauds CMS for clearly articulating that restricting access to HCV treatments solely on the basis of cost and using medically unjustifiable criteria is unacceptable.'”