Alabama Medicaid discriminates against drug users, federal complaint says

An Alabama Medicaid coverage that requires hepatitis C sufferers to keep away from medication and alcohol for six months or lose entry to lifesaving remedy violates the People with Disabilities Act, in response to a federal administrative criticism.

AIDS Alabama and the Harvard Middle for Well being Regulation and Coverage Innovation filed the criticism Monday with the U.S. Division of Justice. The People with Disabilities Act protects individuals who use medication from discrimination in medical care.

The Alabama Medicaid Company covers the price of prescription remedy for folks in this system, together with a number of FDA-approved therapies for hepatitis C. This system requires sufferers to show they haven’t used medication or alcohol within the final six months, which prevents individuals who use substances from getting remedy for the virus.

Alabama is one in every of 5 states with six-month sobriety necessities, together with Arkansas, Mississippi, South Carolina and South Dakota. Since 2017, 17 states have dropped comparable necessities.

“Alabama’s well being outcomes at all times appear to be among the many worst within the nation,” stated Kathie Hiers, CEO of AIDS Alabama, in a press launch. “Insurance policies that forestall enough medical care from being offered should finish. HCV now has a treatment and withholding that treatment from Alabamians primarily based on an ethical judgement is unsuitable and positively doesn’t comply with the science.”

Sobriety necessities go towards remedy tips from medical organizations such because the American Affiliation for the Examine of Liver Illness and the Infectious Ailments Society of America, in response to the criticism. Research cited within the criticism discovered that drug and alcohol customers benefited from medicines used to eradicate the hepatitis C virus.

A spokesman for the Alabama Medicaid Company didn’t reply to a request for remark.

Hepatitis C spreads by way of contact with an contaminated particular person’s blood. Individuals who acquired blood transfusions or organ transplants earlier than 1992 and injection drug customers are at excessive danger for an infection.

The variety of folks with hepatitis C elevated quickly between 2005 and 2017, pushed partially by will increase in opioid use. Many individuals contaminated with the virus haven’t any signs, however others can endure from liver scarring, most cancers and even dying. Drugs that eradicate the virus are medically mandatory for all who take a look at constructive, no matter drug use, the criticism alleges.

“Compelled sobriety insurance policies don’t simply unfairly forestall folks with substance use dysfunction from accessing life-saving remedy; in addition they severely hamper public well being efforts to cease the unfold of the illness,” stated Kevin Costello, Harvard Middle for Well being Regulation and Coverage Innovation Litigation Director, in a press launch. “These insurance policies are rooted in stigma, not science, they usually violate antidiscrimination provisions of the People with Disabilities Act. Submitting an administrative criticism towards Alabama is a vital milestone in preventing sobriety restrictions, and we totally intend to develop this enforcement marketing campaign to all states the place sobriety restrictions persist.”