Dear Friends,

Do you have a client who has received a Medicaid denial for one of the new hepatitis C medications — Harvoni, Sovaldi, Daklinza, Vikeira Pak, or Zepatier?  The Legal Aid Society is challenging the NYS Department of Health’s clinical criteria for hep C drugs and would like to speak with advocates who are assisting clients with denials.
 
In 2013 through 2015, new medications were approved by the FDA that cure hepatitis C virus at rates from 90% to 99%.  The NYS Department of Health implemented clinical criteria that significantly limit access to these life-saving drugs.  (Clickhere to read an October 2014 Medicaid update containing information about this.)  Most of the Medicaid managed care plans have adopted the DOH’s formulary and prior authorization requirements.
 
Please contact me if you are working with someone who has been denied one of these drugs, and I will put you in touch with the Legal Aid lawyer working on the matter.

All the best,
Alex