Rivero Mestre Team Gets 2 Settlements for Hepatitis C Insurance Coverage
Andres Rivero, Jorge A. Mestre, Charlie E. Whorton, Alan H. Rolnick and Amanda M. McGovernRivero MestreRivero Mestre attorneys filed class actions…
December 11, 2017 at 06:00 AM
2 minute read
Andres Rivero, Jorge A. Mestre, Charlie E. Whorton, Alan H. Rolnick and Amanda M. McGovern
Rivero Mestre
Rivero Mestre attorneys filed class actions against UnitedHealthCare Services Inc. and Florida Blue to obtain insurance coverage for almost 9,000 insureds nationwide after they were denied coverage for Harvoni, the first-ever cure for hepatitis C.
The U.S. Food and Drug Administration approved Harvoni in October 2014 and gave it a rare breakthrough therapy label. It cures hepatitis C in 99 percent of cases with almost no side effects.
But the cure comes at a steep price tag starting at $63,000 for the shortest course of treatment, which prompted some insurers to deny coverage and set stringent conditions.
Rivero Mestre successfully obtained class-action settlements with United and Florida Blue to pay for Harvoni coverage. The two settlements obtained coverage on behalf of about 9,000 people and are conservatively valued at over $500 million.
A West Palm Beach federal judge gave final approval in January in the United case after rejecting a challenge from 14 state attorneys general. Under the settlement, the insurer removed a requirement that policyholders demonstrate abstinence from drug and alcohol use for at least six months before treatment.
The Florida Blue settlement received final approval in August 2016.
Charlie Whorton, one of the attorneys from the Coral Gables firm pursuing the litigation, said major health insurance companies across the country have changed their guidelines to lift restrictions since the cases began. He said the result made it “one of the most gratifying cases” pursued by the firm.
Rivero Mestre partners Andres Rivero, Jorge A. Mestre, Alan H. Rolnick, Amanda M. McGovern and Whorton worked on the case along with team members Daniel Alvarez Sox and Bryan L. Paschal.
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