Montana has lifted what had been considered one of the nation’s most restrictive policies regarding granting coverage of hepatitis C virus (HCV) treatment through the state’s Medicaid program.
The move was lauded by the National Viral Hepatitis Roundtable (NVHR), a national group that seeks to combat viral hepatitis across the country, as well as Harvard Law School’s Center for Health Law and Policy Innovation (CHLPI).
The NVHR and CHLPI had previously given Montana’s Medicaid program, along with those of only two other states, an F rating as a part of the groups’ Hepatitis C: The State of Medicaid Access Report. The rock-bottom rating reflected what the groups characterized as discriminatory restrictions on access to direct-acting antiviral (DAA) treatments for hep C.
Until the recent lifting of these restrictions, Montana required that for Medicaid to provide coverage for DAAs, people with hep C needed to have advanced fibrosis (scarring of the liver) or cirrhosis, specifically a grade of F3 fibrosis or greater; to be off substances for six months or longer; and to receive a prescription for DAAs from a specialist. It can be particularly difficult to secure an appointment with a liver or infectious disease specialist in heavily rural states such as Montana, where they are in short supply.
The Centers for Medicare & Medicaid Services, the American Association for the Study of Liver Diseases and the Infectious Disease Society of America all recommend universal access to HCV treatment.
“Hepatitis C is the nation’s deadliest infectious disease, and Montana’s discriminatory access restrictions had been preventing or delaying treatment for the 7,400 Montanans who are living with the hepatitis C virus,” NVHR director Lauren Canary said in a press release. “This is an important step toward the elimination of viral hepatitis in the U.S. We applaud Montana for removing these restrictions and helping to ensure that those Montanans who need it now have access to a cure for this treatable disease.”
“Montana’s discriminatory restrictions were standing in the way of eliminating hepatitis C,” said Robert Greenwald, a clinical professor of law at Harvard Law School and the director of CHLPI. “We are grateful that Montana has joined the many state Medicaid programs across the country that have eliminated illegal and medically unfounded hepatitis C treatment restrictions.”
To read a press release about the shift in the law, click here.
To read the full Montana report card, click here.