Originally published by the Providence News Journal on October 29, 2018. Written by Rob Borkowski.
The R.I. Executive Office of Health and Human Services removed all restrictions on curative hepatitis C treatments for its Medicaid patients on July 12, a move that the National Viral Hepatitis Roundtable and the Center for Health and Law Policy Innovation at Harvard Law School took note of in upgrading the state’s report card for the Hepatitis C: The State of Medicaid Access project from a “D-” to an “A-”.
Rhode Island’s decision improved access to the treatments for Medicaid patients in both its Fee-for-Service and Managed Care Organization Medicaid programs. Previously, the state restrictions on access to hepatitis C treatments were not in line with federal medical necessity requirements for Medicaid.
But the state worked in conjunction with the Center for Health and Law Policy Innovation, the Rhode Island Center for Justice and other community partners to make the policy change.
“We commend Rhode Island for expanding access to hepatitis C medications for all Medicaid beneficiaries, ensuring that more Rhode Islanders can receive curative treatments. CHLPI encourages other states to follow in Rhode Island’s footsteps and remove their discriminatory restrictions,” said Robert Greenwald, clinical professor of law at Harvard Law School and the director of CHLPI.
Rhode Island’s Fee-For-Service program previously required hepatitis C patients to demonstrate severe liver damage (a fibrosis score of F3 or greater), undergo screening and concurrent alcohol and substance use counseling for beneficiaries actively using, and obtain a prescription from a specialist that is approved by the R.I. Executive Office of Health and Human Services. With these restrictions in place, very few patients diagnosed with hepatitis C had access to treatment. Each year, it is estimated that only 250 Rhode Islanders who are Medicaid beneficiaries receive access to curative hepatitis C medications.
“After years of strong advocacy efforts in Rhode Island, all Medicaid patients diagnosed with hepatitis C can now receive access to treatment without restrictions. We continue to encourage all Medicaid patients at risk to undergo screening and learn about available treatment options,” said Tina Broder, interim executive director of the National Viral Hepatitis Roundtable.