Hepatitis C: Class Action Suit

Rivero Mestre is currently investigating claims by insureds of the health insurance product called Ambetter, which is issued by Centene Corporation, Inc. (“Centene”) through its wholly-owned subsidiaries, such as Sunshine Health, Celtic, Health Net, and others. Rivero Mestre is also currently investigating claims by insureds of health insurance products issued by Molina Healthcare (“Molina”).

Rivero Mestre is investigating whether these companies are unlawfully denying coverage to insureds with hepatitis C—a potentially fatal and seriously debilitating disease—which scars the liver, making it increasingly fibrotic, then cirrhotic, until it no longer functions, resulting in liver failure and potentially death. Since October 2014, drug treatments that cure hepatitis C have been available, including Harvoni, Epclusa, Viekira Pak, Zepatier, Mavyret, and others. Insureds have asked Centene and Molina to pay for the cures because the health insurance policies they purchased cover any treatments that are medically necessary. Centene and Molina have denied these requests in furtherance of an unlawful cost-avoidance scheme, whereby they refuse to cover and pay for a cure unless an insured already has suffered severe, irreparable liver damage.

This conduct constitutes an unfair and deceptive trade practice, as well as tortious interference with the uniform contractual promise in those health insurance policies to provide coverage, and pay for, medically necessary treatment. Accordingly, Rivero Mestre is investigating claims against Centene and Molina in order to force them to provide coverage for the cures.

If you have been denied coverage for any hepatitis C drug, please call Rivero Mestre at 305-445-2500, or submit the form below.