Ask Your Doctor About Getting Treatment For Hepatitis C
Class Action Settlement – Coleman v. Young
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To all Texas Medicaid members living with the Hepatitis C Virus:
Starting on September 1, 2021 – if you want your doctor to give you treatment for Hepatitis C, Medicaid may cover the medicine you need without considering the level of your illness, the specialty of your doctor, and without any need to have a drug screening. This is true even if you have previously been denied coverage.
Individuals previously prescribed these life-saving medications for Hepatitis C, but who were denied this treatment based on their fibrosis score, can and should re-apply to receive approval for treatment.
Texas will have a new policy for all its Medicaid members that means that many of the restrictions that previously blocked people from getting treatment for Hepatitis C are now removed.
WHY NOW?
In 2020, three individuals infected with Hepatitis C Virus—with the help of Edwards Law, Latham & Watkins LLP, and the Harvard Law School Center for Health Law and Policy Innovation—challenged the rules for Hepatitis C treatment coverage used by the Texas Health & Human Services Commission – also known as HHSC – by filing a class action lawsuit on behalf of thousands of Texans. Eventually, HHSC, which administers the state’s Medicaid program, agreed to eliminate its restrictive treatment criteria, effective on September 1, 2021.
For more information on this Hepatitis C treatment criteria change, check out the Frequently Asked Questions and the key documents from this class action settlement for Coleman v. Young (Civil Action Number 1:20-CV-00847-RP) below.
Frequently Asked Questions
WHO DOES THIS APPLY TO?
This change affects all individuals who are:
- Living with the Hepatitis C virus;
- Are enrolled in the Texas Medicaid Program – including those who receive their Medicaid benefits through one of the 17 managed care companies listed below;
- Who have been or will be prescribed DAA treatment by a doctor; and
- Who have not already completed a course of DAA treatment and been cured.
If you are currently enrolled in Texas Medicaid and you are living with Hepatitis C, talk to your doctor now about getting treatment.
The State of Texas works with private health insurance companies to provide Medicaid. Here is a list of the companies that work with Texas Medicaid:
- Aetna
- Amerigroup
- BlueCross BlueShield of Texas
- Cigna-HealthSpring
- Community Health First Plans
- Community Health Choice
- Cook Children’s
- Dell Children’s Health Plan
- Driscoll
- El Paso First Health
- FirstCare
- Molina Healthcare of Texas
- Parkland Community Health
- Scott & White
- Superior HealthPlan
- Texas Children’s
- UnitedHealthcare
IF THIS APPLIES TO ME, WHAT SHOULD I DO?
- Go to your doctor, and ask (again) for treatment for Hepatitis C. You will no longer be denied because of your fibrosis score.
- The Court will decide whether to approve or reject the proposed Settlement Agreement after a Final Hearing on November 22, 2021, at 1:00 p.m. at the United States District Court for the Western District of Texas at 501 West Fifth Street, Suite 1100, Austin, Texas 78701.
- You do not have to attend the hearing, but you can if you want to.
- You can send comments instead of coming to the hearing. Comments must be in writing. You may comment on, object to, or show your support for this Settlement Agreement. All comments, objections or showings of support for the settlement should be sent on or before October 15, 2021.
- You must send written comments to the judge before the hearing. You may attend the hearing, and you may bring a legal representative if you wish at your own expense. You must send the judge a letter before the hearing if you want the judge to allow you to speak at the hearing. Any letters must be sent to:
Clerk of Court, Coleman v. Young
Civil Action Number 1:20-CV-00847-RP
United States District Court for the Western District of Texas
501 West Fifth Street, Suite 1100
Austin, Texas 78701
Letters should also be copied to these attorneys on the case:
Attorney for Plaintiffs:
Kevin Costello
Center for Health Law & Policy Innovation
Harvard Law School
1585 Massachusetts Avenue
Cambridge, MA 02138
Attorney for Defendants:
Michael Abrams
Assistant Attorney General
Office of the Attorney General
P.O. Box 12548, Capitol Station
Austin, Texas 78711-2548
WHERE CAN I FIND MORE INFORMATION?
- Contact Class Counsel with any additional questions:
- Telephone: (737) 235-8641
- Email: texasmedicaidhepc@gmail.com