New York AG Sues Health Insurer Over Hepatitis C Treatment

April 19, 2016

New York’s attorney general has filed a lawsuit against an Albany-area health insurer that he says broke the law by denying coverage for expensive hepatitis C treatments until patients showed advanced symptoms of the disease such as moderate to severe liver scarring.

Attorney General Eric Schneiderman announced the suit against Capital District Physicians’ Health Plan on April 14. It claims the insurer refused to cover hepatitis C drugs because of the price of the treatment — but failed to notify customers that cost was a factor in coverage decisions.

Schneiderman says consumers expect insurers to cover treatments for serious diseases like hepatitis.

A spokeswoman for Capital District Physicians’ Health Plan says the insurer’s policies on hepatitis C treatment are “comparable” to other health plans and even the state’s own Medicaid program.

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