Tuesday, April 26, 2016

New York Insurers to Change Coverage of Hepatitis C Drugs

New York Insurers to Change Coverage of Hepatitis C Drugs
By Corinne Ramey                
April 25, 2016 10:00 p.m. ET

Seven health-insurance companies in New York will change their criteria for covering costly drugs that cure chronic hepatitis C under the terms of agreements with the office of State Attorney General Eric Schneiderman.

The agreements, expected to be announced Tuesday, require the insurers to cover hepatitis C medications for nearly all patients who have commercial insurance plans in the state.

Last year, Mr. Schneiderman’s office began an investigation into coverage of drugs for chronic hepatitis C, issuing subpoenas for documents and claims data to all commercial health insurers in the state. The investigation showed a wide discrepancy in how companies cover these drugs and found some insurers largely covered only patients with advanced stages of the disease, the attorney general’s office said.

Five of the insurers denied from 30% to 70% of claims, the office said.

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