NY Attorney General Sues CDPHP For Unlawfully Denying Coverage Of HCV Treatment

(RTTNews) - New York Attorney General Eric Schneiderman has filed a lawsuit against health insurer Capital District Physician's Health Plan for unlawfully denying coverage of Hepatitis C treatment. The lawsuit alleges that CDPHP denied coverage for HCV treatment unless the member demonstrated advanced disease. The lawsuit further alleges that by failing to fully disclose the definition of "medically necessary" used in determining when benefits will be covered, CDPHP is violating the New York State Insurance Law and Public Health Law.

Attorney General Schneiderman said: "Forcing patients to wait for care, risking internal organ damage, is unconscionable and, as we allege in our lawsuit, violates the law and the company's own policies."

CDPHP has approximately 450,000 members in New York State and provides service to 24 counties throughout the Capital Region, North Country, Hudson Valley, Central New York, and the Southern Tier.

The statement from A.G. Schneiderman noted that the lawsuit is part of a continuing investigation into numerous health insurers for improperly restricting coverage of Hepatitis C treatments.