State Medicaid could see increases in hepatitis C and autism treatments

Posted: Published on March 18th, 2015

This post was added by Dr Simmons

The Legislature's Appropriations Committee heard from state health officials Monday that millions of dollars will be needed for new hepatitis C treatments for Medicaid recipients.

The treatment for hepatitis C, a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness, could cost nearly $6.5 million in the next two-year budget, said Calder Lynch, the new director of Medicaid and Long-term Care for the Department of Health and Human Services.

The illness results from infection by the hepatitis C virus, which is spread primarily through contact with the blood of an infected person.

Lynch also told the committee the department is involved in a lawsuit regarding providing Medicaid behavioral health services for children on the autism spectrum and with developmental disabilities.

At issue is coverage of intensive behavior interventions as an appropriate treatment for children with autism. It is estimated that 2,305 Nebraska children covered by Medicaid would be able to receive the treatments over a full 12 months.

If the court would also order intensive behavior interventions for children with developmental disabilities, outside the autism spectrum, that could add another 781 children.

The cost for the treatments would be about $41 million, Lynch said.

The department is asking to use unspent money in other Medicaid and children's insurance programs for the cost.

Lincoln Sen. Kate Bolz told Lynch it was worth exploring the assumptions of who would qualify for the autism treatments and costs.

Increases in the number of hepatitis C cases in the Department of Correctional Services also is taking extra money from the state general fund. Payments for 72 inmates a year -- plus one-time lab fees for each -- was estimated at $11.7 million for fiscal year 2015-16 and $13 million for 2016-17.

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State Medicaid could see increases in hepatitis C and autism treatments

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