Medicaid Patients Win: Justice Dept & DHHS Urge Access to HepC Cure for Patients with Substance Use Disorder 

On January 26, 2024, The Department of Justice and the Department of Health and Human Services (HHS) issued a joint letter to state Medicaid administrators urging them to ensure, in accordance with the Americans with Disabilities Act (ADA), that their Medicaid programs allow people who have both Hepatitis C (HCV) and substance use disorder (SUD) to access life-saving HCV medications called direct-acting antivirals (DAAs). 

The letter cites a settlement agreement in Alabama that resulted from an administrative complaint CHLPI and AIDS Alabama filed with the DOJ in 2022. The Alabama complaint drew on CHLPI’s novel legal theory that the Americans with Disabilities Act prohibits sobriety-based restrictions on hepatitis C treatment. Months after the complaint, on October 1, 2022, Alabama Medicaid announced that it was removing sobriety-related restrictions to lifesaving Hepatitis C (HCV) treatment. Read our press release of the announcement.

“We are thrilled that Alabama Medicaid has decided to remove this discriminatory barrier to HCV treatment for people with substance use disorder,” said Kevin Costello, Litigation Director for CHLPI, at the time of the Alabama announcement. “It is not only illegal to deny a person critical HCV care based on substance use, but it is squarely outside of the standard practice of care. DAA treatments are recommended for all patients with chronic HCV infection, regardless of drug or alcohol use, and they are our best tool in eliminating the spread of this deadly disease.”

CHLPI applauds the Department of Justice for taking this important step of reminding state Medicaid programs of their responsibility to treat individuals living with SUD fairly.  “It is heartening to see DOJ exercise the enforcement authority reflected in the Alabama settlement, as well as the supervisory authority illustrated by the January 24 guidance.  We look forward to continuing our work with DOJ until every state ceases discriminatory restrictions on treatment for Hepatitis C,” Costello said.