Alabama lifts hepatitis C Medicaid rule advocates say discriminated against drug users

Originally written by Amy Yurkanin and published on AL.com on September 28, 2022.

Officials at the Alabama Medicaid Agency have ended a rule that required patients to stop using drugs and alcohol for six months before receiving life-saving medication for the liver disease hepatitis C.

The new policy will go into effect on Oct. 1, according to a provider alert on the agency’s website. 

The change was announced more than five months after AIDS Alabama and the Harvard Center for Health Law and Policy filed an administrative complaint with the U.S. Department of Justice saying the requirement violated the rights of people who use drugs.

Suzanne Davies, clinical fellow and attorney for the Center, said withholding medication from people with addiction violates the Americans with Disabilities Act. She said staff members from the Department of Justice said they were going to investigate the complaint before Alabama changed its policy.

“There are many more people who will be able to access treatment after this change,” Davies said.

Hepatitis C is a virus that attacks the liver. It can be spread from contact with contaminated blood, including by people who use IV drugs.

The virus may cause no symptoms for many years and then lead to scarring and cancer of the liver. Many people don’t know they have it and can pass it on to others. The number of people with hepatitis C soared between 2005 and 2019, according to the CDC.

Several medications have become available to treat hepatitis C. The first treatments for the disease cost tens of thousands of dollars, but in recent years, costs have come down, Davies said.

Alabama still imposes some hurdles that make it more difficult for Medicaid patients to obtain antiviral drugs, Davies said. 

Patients must go through a preauthorization process with their doctor which can be difficult for people with few resources and housing instability.

Although she said she would like to see more done to increase access to medication, Davies said the end of sobriety requirements are an important first step.

“Even if nothing else changes, this will allow many more people to obtain this treatment,” Davies said.