Following a federal court ruling last month, Florida corrections officials are challenging a judge’s order to expand access to hepatitis C virus (HCV) treatment for prisoners, WUSF news reports.

It is the latest move in a protracted legal battle between the Florida Department of Corrections and prison advocates over the state’s handling of thousands of inmates with the virus. The judge’s ruling, which found the agency was “deliberately indifferent” to HCV-positive inmates, could add between 20,000 and 40,000 inmates to about 7,000 already ordered to receive treatment.

The ruling follows a class-action lawsuit filed in 2017 on behalf of Florida inmates. In a December 2017 injunction, Chief U.S. District Judge Mark Walker had already ordered the state to devise a plan to properly treat inmates and file monthly status reports showing the agency’s compliance with his mandate. This latest ruling expands hepatitis C treatment to inmates at early stages of the virus  and requires corrections officials to adopt a system of either opt-out testing combined with “an aggressive notice campaign” for HCV or opt-in testing combined with peer education.

The Florida Department of Corrections has long blamed lack of funding for its inability to provide treatment, noting that a single course of treatment can cost up to $37,000 per inmate. Although the notice of appeal does not specify which aspects of Walker’s order the agency is contesting, other court filings suggest the Department of Corrections may not wish to comply with the order to treat inmates with early-stage hepatitis C.

“FDC can no longer use resource limitations and implementation difficulties as an excuse to delay treatment,” Walker said, noting that in May, Florida lawmakers passed a $50 million budget to treat inmates with hepatitis C.