NVHR Press Release: Louisiana Medicaid Program Improves Hepatitis C Treatment Access for Some Patients, But More Progress is Needed to Ensure Access to a Cure for Those Who Need It

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Louisiana Medicaid Program Improves Hepatitis C Treatment Access for Some Patients, But More Progress is Needed to Ensure Access to a Cure for Those Who Need It


NVHR and Harvard Law Upgrade Report Card Grade for Louisiana Medicaid Program from an ‘F’ to ‘C’ After Prescriber Restrictions Removed and Sobriety Requirements Reduced


August 16, 2018 – The National Viral Hepatitis Roundtable (NVHR) and the Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) announced today that they updated the Louisiana scorecard in their Hepatitis C: The State of Medicaid Access report from an “F” to “C” to reflect improved access to treatments for some patients living  with the hepatitis C virus (HCV) in Louisiana Fee-for-Service (FFS) and Managed Care Organizations (MCO) programs.


Louisiana is one of five states that originally received an “F” for its Medicaid programs that imposed discriminatory restrictions on hepatitis C cures. Since the release of the “Hepatitis C: State of Medicaid Access” project, Louisiana’s FFS and MCO programs have removed restrictions that a specialist is required to prescribe the medication and have eased restrictions based on sobriety.


“Hepatitis C is the nation’s deadliest infectious disease and these restrictions prevent access to care for thousands of Louisianans,” said Robert Greenwald, Clinical Professor of Law at Harvard Law School and the director of CHLPI. “We encourage Louisiana to continue removing these discriminatory hepatitis C treatment restrictions. We believe that all Medicaid patients should have access to a cure for this treatable disease.”


Louisiana’s Fee-For-Service (FFS) Program previously required hepatitis C patients to demonstrate severe liver damage (a fibrosis score of F3 or greater), 12 months of sobriety confirmed by a negative urine screen and blood alcohol level within 30 days of beginning treatment and a prescription from a specialist. In May 2018, Louisiana’s FFS and MCO programs removed all prescriber restrictions and now only require beneficiaries to attest that they have not been “actively participating” in substance and/or alcohol abuse.


“We applaud Louisiana for removing some Medicaid restrictions on treatment, however there is still more progress to be made. The state’s requirement that a patient have severe liver damage before accessing a cure remains intact and unnecessarily blocks access to treatment for many currently infected with hepatitis C,” said Tina Broder, interim executive director of NVHR.


“Louisiana has some of the highest rates of hepatitis C infections in the entire country. We must work to reduce these Medicaid restrictions on treatment, particularly as the opioid epidemic continues to increase the rate of new infections.” said Kevin Costello, Litigation Director and Associate Director of Health Care Access at CHLPI. “Disease severity restrictions in Louisiana Medicaid — a unique rationing technique applied Hepatitis C patients and no one else — remain as an illegal barrier to HCV elimination in the state. CHLPI and NVHR continue to condemn this practice, regardless of marginal improvements in other areas. As part of a national campaign to end such practices, advocates will continue to leave all health care rights enforcement options on the table.”


Hepatitis C: State of Medicaid Access – which is available online in interactive form at http://stateofhepc.org – 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.


States that currently have an “A” include: Alaska, Colorado, Connecticut, Delaware, Massachusetts, Missouri, Nevada, New Mexico, Pennsylvania, Vermont and Washington. States that now have an “F” are: Arkansas, Montana and South Dakota. Most states – 17 and Puerto Rico – have a “D” grade.


Read the full Louisiana report card here.


About the National Viral Hepatitis Roundtable (NVHR)
The National Viral Hepatitis Roundtable is a national coalition working together to eliminate hepatitis B and C in the United States. NVHR’s vision is a healthier world without hepatitis B and C. NVHR’s work is guided and informed by our beliefs and commitment to: Participation, Inclusiveness, Intersectionality, Health Equity, and Stigma Elimination. For more information, visit www.nvhr.org.


About the Center for Health Law and Policy Innovation of Harvard Law School (CHLPI)

The Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) advocates for legal, regulatory, and policy reforms to improve the health of underserved populations, with a focus on the needs of low-income people living with chronic illnesses and disabilities. CHLPI works with consumers, advocates, community-based organizations, health and social services professionals, government officials, and others to expand access to high-quality healthcare; to reduce health disparities; to develop community advocacy capacity; and to promote more equitable and effective healthcare systems. CHLPI is a clinical teaching program of Harvard Law School and mentors students to become skilled, innovative, and thoughtful practitioners as well as leaders in health, public health, and food law and policy. For more information, visit http://www.chlpi.org.