CHLPI & NVHR Launch Interactive Report Card Project Grading 52 Medicaid Programs for Discriminatory Hepatitis C Treatment Restrictions

The Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) and the National Viral Hepatitis Roundtable (NVHR) today released Hepatitis C: State of Medicaid Access—a report and interactive project grading all 50 state Medicaid programs, as well as the District of Columbia and Puerto Rico, according to access to curative treatments for hepatitis C, the nation’s deadliest infectious disease. More than half of Medicaid programs (52 percent) received a “D” or an “F” for imposing discriminatory restrictions on hepatitis C cures.

Hepatitis C: State of Medicaid Access—which is available online in interactive form and unveiled today at the American Association for the Study of Liver Diseases (AASLD) Liver Meeting in Washington, D.C.—grades each state, as well as the District of Columbia and Puerto Rico, according to its overall “state of access.” Each grade is determined by curative treatment restrictions related to three areas: 1) liver disease progression (fibrosis) restrictions, 2) sobriety/substance use requirements, and 3) prescriber limitations—all of which contradict guidance from the Centers for Medicare & Medicaid Services (CMS), as well as recommendations from AASLD and the Infectious Disease Society of America. The report also offers suggestions for each state to reduce its treatment access requirements.

“At least 3.5 million Americans are infected with hepatitis C in an epidemic that has eclipsed all other infectious diseases in the U.S. and has been exacerbated by the opioid crisis,” said Ryan Clary, executive director of NVHR. “Giving Medicaid recipients broad access to curative treatments is critical if we are really serious about ending this country’s deadliest infectious disease. Our hope with this project is to provide a roadmap for states—and the Centers for Medicare & Medicaid Services—in order to get more people treated, cured and ultimately protected from hepatitis C.”

“While more than half of states still received a D or an F in the report for discriminatory restrictions on hepatitis C treatment, we have seen some progress since 2014, when our analysis indicated that 42 state Medicaid programs could be violating federal Medicaid law,” said Robert Greenwald, Clinical Professor of Law at Harvard Law School and the director of CHLPI. “States with the best grades have taken steps to ensure widespread access to hepatitis C treatments. These states should serve as a model for those still rationing access to a hepatitis C cure based on outdated cost concerns, rules that stigmatize those living with hepatitis C, and non-medically indicated treatment criteria.”

States that received an “A” are: Alaska, Connecticut, Massachusetts, Nevada, and Washington. States that received an “F” are: Arkansas, Louisiana, Montana, Oregon, and South Dakota. Most states—21 and Puerto Rico—received a “D.”

On its interactive site, Hepatitis C: State of Medicaid Access also includes ways to get involved. Users are invited to share their stories, sign a petition calling for better treatment access, and advocate for the issue on social media.

Media Coverage

STAT | Some state Medicaid programs continue to restrict access to hepatitis C drugs

Politico Pro | Report criticizes transparency of managed care plans on hep C

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