YAKIMA, Wash. -- Washington Medicaid clients with hepatitis C will soon receive official notice that the state can no longer deny them access to the virus’s cure, thanks to a new order in a statewide lawsuit.
The lawsuit against the state Health Care Authority, which administers Medicaid, successfully gained an injunction in May requiring the agency to drop its previous exclusions for coverage of curative hep C drugs based on patients’ disease progression.
Under those exclusions, 900 people statewide were denied access to expensive drugs such as Harvoni, which cures the infectious disease in more than 90 percent of patients in 12 weeks.
But while the injunction was handed down two months ago, the state has yet to notify patients of their new eligibility for the medication. In a June 15 court filing, the Health Care Authority wrote it intended to inform previously denied patients but all the agency has sent out so far is an alert informing medical providers of the change in policy.
However, an order from the judge in the case last week granting class certification to the lawsuit included a requirement that the state submit official notice to the court, which the court must approve before it goes out to patients. And lawyers representing the class of affected patients get to have a say in what goes in that notice.
Attorney Amy Crewdson of Columbia Legal Services, one of the law firms who brought the initial lawsuit, said it's anticipated the notice will go out next month, depending on how quickly both sides and the judge can agree on the language.
The notice also will include information about Columbia Legal Services as representatives of the class, Crewdson said.
“Now people who get the notice ... will know that there are lawyers involved who are working on their behalf,” she said.
Without the required notice, Medicaid hep C patients would likely only know about the court ruling if they read about it in the newspaper, or happened to hear from their doctor.
Also, Crewdson said, if the case doesn’t settle — if the state fights to keep the court’s injunction from being permanent, for example — class certification gives the attorneys more latitude.
“We now have the ability as class counsel to go forward as class counsel and litigate the case on behalf of everyone affected, every class member,” she said.
That’s a significant number of people: The class includes all 900 Medicaid patients who were previously denied coverage for hep C treatment, as well as the estimated 22,000 clients on Washington Medicaid who have hep C and may require the expensive treatment in the future.
Many in that estimate may not even be aware yet that they have the virus, Crewdson said.
A report from the state Department of Health on Wednesday estimates that 90,000 people statewide (not just within Medicaid) are likely infected with hep C.
The report adds that about 550 hep C-related hospitalizations occur in Washington every year, costing around $22 million.
• Molly Rosbach can be reached at 509-577-7728 or firstname.lastname@example.org.