Health Care Service Hepatitis C Drug Class Action Settlement

A $200,000 class action settlement will benefit persons covered by an HCSC prescription drug plan and who need medication for hepatitis C.

Plaintiff Mark Shank says defendant Health Care Service Corp. (HCSC) improperly limited insurance coverage for the hepatitis C drug Harvoni only to patients who have advanced liver scarring, known as fibrosis.

Harvoni is a brand name for a medication that combines the drugs ledipasvir and sofosbuvir. It is FDA-approved to treat the hepatitis C virus.

Shank’s HCSC lawsuit also names Blue Cross Blue Shield of Illinois as a defendant. Shank’s own denial for Harvoni came from Blue Cross Blue Shield, which contracted with HCSC to administer prescription drug coverage.

A third defendant, Prime Theraputics LLC, was dismissed from the action in November 2016.

The HCSC class action settlement requires HCSC to stop restricting coverage for Harvoni based on levels of hepatic fibrosis. This restriction will be lifted effective June 1, 2016, and HCSC may not reinstate it for one year after the effective date of the settlement.

Certain Class Members may qualify for payments from a $200,000 settlement fund. The requirements for payments are fairly detailed, and not all Class Members qualify. Class Members should consult the settlement website for details and contact the settlement administrator with any questions.

The deadline for Class Members to submit exclusions or objections was Jan. 8, 2018.

Who’s Eligible

Members of the Settlement Class include persons who:

• Were covered under any commercial health benefits plan, health insurance policy, or HMO contract with a medical or prescription drug benefit administered by HCSC;
• Whose request for prior authorization or coverage for Harvoni was denied by HCSC between July 1, 2015 and May 31, 2016 based in whole or in part on a fibrosis restriction; and
• Who did not subsequently receive authorization or coverage for a hepatitis C drug under a plan insured or administered by HCSC prior to June 1, 2016.

A fibrosis restriction is a requirement that a patient have a certain minimal level of hepatic fibrosis before the insurer will provide coverage for Harvoni.

Potential Award

Up to $2,676 for certain Class Members.

HCSC has agreed to remove all fibrosis restrictions from its coverage for Harvoni effective June 1, 2016. Class Members are entitled to receive notice of that change. HCSC has agreed not to reinstate that restriction for at least one year following the effective date of this settlement agreement.

Certain Class Members (though not all) may qualify for settlement payments. A Class Member may qualify for payment if, as of Oct. 26, 2017:

• The Class Member has not been previously treated with Harvoni or another hepatitis C drug;
• The Class Member is not covered under a commercial health benefits plan, health insurance policy, or HMO contract with a prescription drug benefit insured or administered by HCSC and which utilizes HCSC’s Prescription Drug Coverage Guidelines for Harvoni; and either
• The Class Member does not have any health benefits through a commercial health benefits plan, health insurance policy, or HMO contract, or through Medicare, Medicaid, or any other government-funded health coverage program; or
• The Class Member’s current health benefits provider has denied coverage for a hepatitis C drug because of a failure to have a specific level of hepatic fibrosis within 180 days prior to Jan. 23, 2018.

Qualifying Class Members may receive payments as large as $2,676. Payment amounts may be reduced, depending on the number of claims received.

Proof of Purchase

As applicable, Class Members are required to provide supporting documentation that shows they were denied coverage for a hepatitis C drug within 180 days prior to Jan. 23, 2018 because they did not reach a specific level of hepatic fibrosis.

Claim Form

CLICK HERE TO FILE A CLAIM »

NOTE: If you do not qualify for this settlement do NOT file a claim.

Remember: you are submitting your claim under penalty of perjury. You are also harming other eligible Class Members by submitting a fraudulent claim. If you’re unsure if you qualify, please read the FAQ section of the Settlement Administrator’s website to ensure you meet all standards (Top Class Actions is not a Settlement Administrator). If you don’t qualify for this settlement, check out our database of other open class action settlements you may be eligible for.

Claim Form Deadline

1/23/2018

Case Name

Shank v. Health Care Service Corp., et al., Case No. 1:16-cv-03993, in the U.S. District Court for the Northern District of Illinois

Final Hearing

3/20/2018

UPDATE: The Health Care Service Hepatitis C Drug Class Action Settlement was granted final approval on March 21, 2018. Let Top Class Actions know when you receive a check in the comments section below or on our  Facebook page.

Settlement Website

www.HepatitisCinsuranceSettlement.com

Claims Administrator

Shank v. HCSC Settlement Administrator
c/o Epiq Systems
P.O. Box 3775
Portland, OR 97208-3775
1-888-752-4075

Class Counsel

Natalie Lesser
KESSLER TOPAZ MELTZER & CHECK LLP

David H. Thompson
COOPER & KIRK PLLC

Defense Counsel

Brian Kavanaugh
Martin Martos
KIRKLAND & ELLIS LLP