Missouri Litigation Clears the Way for Hepatitis C Cure for Medicaid Recipients

Thousands of Missouri Medicaid recipients who suffer from hepatitis C will now be able to get life-saving medicine that will cure their disease after litigation against the Missouri Department of Social Services.

Three individuals on Medicaid, represented by three public interest law offices, filed a lawsuit a year ago challenging a Missouri Medicaid policy that only provided new breakthrough drugs which cure hepatitis C to the sickest people with the disease, those with the most damage to their liver.  Under this policy, Medicaid refused to provide the drugs to people at earlier stages of the disease, even though they faced the threat of liver disease or cancer.  These individuals are represented by the Legal Services of Eastern Missouri, the National Health Law Program and the Saint Louis University Legal Clinics.

In a recent turn of events, the Missouri Department of Social Services changed its policy so that everyone on Medicaid can get access to these new medications that cure hepatitis C with an eight-week regimen.

NHeLP senior attorney Abigail Coursolle said, "Missouri, like too many states, has failed to follow federal and state guidelines on providing their Medicaid beneficiaries with prompt access to Hep C treatment that we know cures this disease. We are glad that Missouri health officials will start to ensure that Medicaid enrollees receive these medications in a timely manner. This therapy is not only medically necessary for the individual patient, but it is vital in helping to halt spread of a communicable disease."

“A medication which can totally cure a disease is a rare occurrence,” said Dr. Bruce Bacon, co-director of the Saint Louis University Liver Center in the Division of Hepatology at Saint Louis University School of Medicine.  “We have hundreds of patients who have been waiting to get this medication for years, and now they will be cured.”  Bacon and his staff partnered with the three legal organizations to advocate for low-income Missourians with the disease.

Drug manufacturers have been producing new drugs that cure hepatitis C for several years, and major health insurers, as well as Medicare and the Veterans Administration have covered the drugs for anyone with hepatitis C.  Now, in response to this lawsuit filed, MO HealthNet, Missouri’s Medicaid program, is paying for these drugs for all patients as well, effective November 1.

“Thousands of people will now have access to a cure for a serious, infectious disease.  For these people and their families, the cure means an end to the worry of a future of liver disease and liver cancer, and an end to daily pain and fatigue that comes with hepatitis C,” said professor John Ammann, the McDonnell Professor of Justice in American Society and one of the lawyers representing the individuals bringing the suit.

Source: Saint Louis University School of Law