ALBANY, N.Y. (Legal Newsline) – New York Attorney General Eric T. Schneiderman announced that his office will take action against Capital District Physician’s Health Plan (CDPHP) by suing the company for allegedly restricting coverage of treatment for chronic hepatitis C infection.
“When consumers purchase health insurance, they rightfully expect that if they are diagnosed with a serious, potentially life-threatening disease like hepatitis C, treatment will be considered ‘medically necessary’ and covered by their insurance," Schneiderman said. “Forcing patients to wait for care, risking internal organ damage, is unconscionable and, as we allege in our lawsuit, violates the law and the company’s own policies.”
Hepatitis C is a blood-borne virus that can cause liver failure, liver cancer, brain damage and kidney failure and can ultimately result in death if left untreated. The Food and Drug Administration has approved many medications to cure hepatitis C, but CDPHP allegedly limited coverage of these types of medications to members with advanced stages of the disease.
Schneiderman’s office believes this is inconsistent with the prevailing treatment guidelines, which recommend treatment of almost all infected individuals.