R.I. Broadens Medicaid Coverage for Treatment of Hepatitis C

Originally published by Providence Journal on July 11, 2018. Written by G. Wayne Miller.

Rhode Island’s Medicaid policy has been revised to cover the costs of treatment for all beneficiaries who are living with the potentially deadly blood-borne Hepatitis C virus. Until now, only those individuals with HCV who were experiencing severe liver damage or cirrhosis were covered by the plan.

The change follows action by the Executive Office of Health and Human Services, the Rhode Island Center for Justice, the Center for Health Law and Policy Innovation of Harvard Law School, and community activists and lawyers from the Jones Kelleher firm to bring the state into compliance with federal guidelines. That action began when a state resident living with the virus received legal representation after initially being denied treatment.

“A comprehensive, public health approach of prevention and screening that now includes treatment for all is key to our goal of eliminating HCV in Rhode Island,” said health department Director Dr. Nicole Alexander-Scott. “Public health, state institutions, clinical organizations, and community agencies need to all work together to address this epidemic and ensure that access to prevention and treatment does not depend on one’s ZIP code, insurance status, or any other factors.”

As many as 22,660 Rhode Islanders have been infected with HCV, according to health department estimates, but since symptoms do not always or immediately develop, many are unaware that they carry the disease. When symptoms do develop, they can progress to irreversible liver damage resulting in death. In 2014, 102 Rhode Islanders died of the disease, compared with 20 who died from the HIV virus.

“This new policy goes to the heart of what Medicaid exists to do: ensure people, regardless of life circumstance, have the medical care and supports they need,” state Medicaid Director Patrick Tigue said. “Few policies have this type of direct, immediate impact on people’s lives. I am thankful for the partnership that made this possible and the leadership our state continues to demonstrate in implementing responsible public health policies that put Rhode Islanders first.”

“Rhode Island has taken an important step here,” said Kevin Costello, head of litigation at the Center for Health Law and Policy Innovation of Harvard Law School. “This change is not only the right thing to do from a public health and legal point of view, but it also been proven that this policy will be cost-effective for the state in the long run.”

“This policy change will directly improve the lives of many of our clients, some of Rhode Island’s most vulnerable citizens,” said Jennifer Wood, executive director of the Rhode Island Center for Justice. “We appreciate the Administration’s partnership on this issue.”

According to the Centers for Disease Control and Prevention, an estimated 3.5 million Americans are affected by HCV. “In 2016, 18,153 U.S. death certificates had HCV recorded as an underlying or contributing cause of death,” the CDC reports. “However, this is a conservative estimate.”

The disease can be transmitted through injection drug use, transfusion of contaminated blood, and, less commonly, sex with an infected person and “unregulated tattooing,” among other ways, according to the CDC.