The state of Illinois has relaxed the official Medicaid policy that allowed only its sickest hepatitis C virus (HCV)-positive beneficiaries to access treatment. Now, those with stage 3 liver scarring or higher will be able to get the latest medications—not just patients diagnosed with stage 4 liver disease, the Chicago Tribune reports.
The announcement comes shortly after local reporters posed several questions to the state about its policy restrictions and whether or not Illinois Medicaid officials had bargained with pharmaceutical companies to reduce state costs for hepatitis C treatment. While the change is likely to open up patient access across Illinois, it is unclear how many people might be helped by the new rules or when the policy will take effect.
So far, hepatitis advocates in Illinois have lauded the policy change as a “positive step forward” but say it doesn’t go far enough. Many are now calling for the state to remove all current restrictions on hepatitis C treatment for its Medicaid beneficiaries, citing 2015 guidance by the Centers for Medicare and Medicaid Services warning that states could be breaking federal laws by restricting access to the drugs in any way.
According to state health officials, at least 12,000 Illinois residents covered by Medicaid were diagnosed with hepatitis C as of last year. But only 753 people in state-run managed care programs received HCV treatment. State records do not show how many people were denied medication prior to the policy change.