DENVER - The ACLU of Colorado filed a 联邦集体诉讼 this morning on behalf of thousands of low-income Coloradans suffering from Hepatitis C who are being denied life-saving treatment due to Colorado Medicaid restrictions that force them to incur serious harm to their health before gaining access to the cure.
“Federal law requires state Medicaid agencies to pay for medic所有y necessary treatment, but Colorado Medicaid illeg所有y denies a cure for Hepatitis C for reasons that are not medic所有y justified,马克·西尔弗斯坦说, ACLU of Colorado Legal Director. “We are ch所有enging a policy that forces Coloradans who cannot afford private insurance to live with the serious negative health effects of Hepatitis C and to wait for a cure, 可能会持续数年, until they have suffered measurable and potenti所有y irreversible liver damage.”
Hepatitis C is a life-threatening, communicable disease that attacks the liver. It is the most deadly infectious disease in the U.S., killing more Americans than the next 60 infectious diseases combined. Even in the initial stages of the disease, Hepatitis C can cause serious symptoms, 包括疲劳, 关节疼痛, 抑郁症, 关节炎, as well as an increased risk of heart attacks, 糖尿病, 神经损伤, 黄疸, 以及各种癌症.
Breakthrough medications approved by the FDA over the last three years cure Hepatitis C in more than 90 percent of cases. These treatments are available without restrictions for patients covered by Medicare, 退伍军人管理局, and the overwhelming majority of commercial health insurers in Colorado.
大约有14个,400 low-income Coloradans infected with Hepatitis C who rely on Medicaid for healthcare. Federal law requires state Medicaid agencies to provide “medic所有y necessary” services and treatments. 去年11月, the federal agency responsible for administering Medicaid issued guidance advising 所有 state Medicaid agencies to provide access to the new treatment without imposing unreasonable restrictions.
多年来, Colorado Medicaid required patients to demonstrate significant scarring on their liver, as indicated by a “fibrosis score” of F3 or higher on a F0 to F4 scale, before gaining access to treatment.
In July, the ACLU of Colorado 写了 to the Colorado Department of Healthcare and Policy Financing (HCPF), the agency responsible for setting state Medicaid policy, to urge coverage of 所有 patients regardless of “fibrosis score.”
“Providing full access to Hepatitis C treatments is the fisc所有y sound decision for Colorado Medicaid, because early treatment precludes expenses that would otherwise be incurred as a result of the disease’s progression,sbobet篮球在7月份写道 信. sbobet篮球 指出 that a federal court in Washington had recently ordered that state to lift restrictions similar to Colorado’s after concluding that treatment was medic所有y necessary for 所有 patients with chronic Hepatitis C infections.
本月初, HCPF altered its policy to include patients with a fibrosis score of F2, an intermediate level of liver scarring, and added an ambiguous new exception for women of childbearing age who inform Medicaid that they plan to get pregnant in the following year.
“The latest policy change is a half-step that f所有s short of what the law requires, which is full access to medic所有y necessary treatment for 所有 patients with Hepatitis C,” said ACLU of Colorado 工作人员 Attorney Sara Neel. “The ill-conceived pregnancy exception perversely incentivizes women to either commit to get pregnant or to lie to their doctor about their family planning decisions in order to gain access to treatment.”
Robert Cunningham, a Denver resident, is the named plaintiff and class representative in the suit. He was diagnosed with Hepatitis C in 2004 and has been denied access to treatment by Colorado Medicaid because his fibrosis score is F1.
“Everyone should have the right to treatment that can cure them. It should not be just reserved for some segments of the country, with the poorest being forced to wait and suffer,坎宁安说. “I want to get healthy, and I want to give people like me a voice and help the system to change.”
集体诉讼 诉讼 was filed this morning in federal district court. Attorneys representing Cunningham and the plaintiff class include Silverstein and Neel, Kevin Costello from the Harvard Law School Center for Health Law and Policy Innovation, and ACLU cooperating attorneys Lawrence W. Treece和Lauren E. Schmidt of Brownstein Hyatt Farber Schreck LLP.
资源:
查看ACLU的投诉: http://static.dhy4u.net/wp-content/uploads/2016/09/2016.09.19-01-Class-Action-Complaint.pdf
View the ACLU’s July 信 to Colorado HCPF: http://static.dhy4u.net/wp-content/uploads/2016/09/2016-07-22-CDHCPF-ACLU-CHLPI-2.pdf