Who is a Class Member
Class members of the Harvoni Hepatitis C Drug Settlement include all persons who “were covered under any type of commercial health benefits plan, health insurance policy, or health maintenance organization contract with a medical benefit or prescription drug benefit (or both) insured or administered by HCSC whose request for prior authorization or coverage of Harvoni was denied by HCSC between July 1, 2015, and May 31, 2016, based in whole or in part on a Fibrosis Restriction, and you did not subsequently receive authorization or coverage for a Hepatitis C Drug under an HCSC-administered or insured plan prior to June 1, 2016.
Note: Harvoni is the trade name for the prescription drug consisting of ledipasvir and sofosbuvir in one pill and currently approved by the U.S. Food and Drug Administration to treat chronic Hepatitis C. A “Fibrosis Restriction” is a requirement that an individual with Hepatitis C demonstrate a specific level of hepatic fibrosis in order to obtain prescription drug coverage for Harvoni from HCSC.
If you don’t qualify for this settlement, check out our database of other class action settlementsyou may be eligible for.
- Up to $2,676.00
HCSC will not pay more than $200K, so if claims exceed this amount, each claimant will receive a pro rata (equal share) of the settlement.
Proof of Purchase
- To qualify for payment, Settlement Class Members must complete and submit the claim form, along with the supporting documentation to prove that your current health benefits provider has denied you coverage for a Hepatitis C Drug within 180 days prior to January 23, 2018. Examples of supporting documentation include the following:
- A letter from your health benefits provider denying your request for prior authorization for Harvoni or another Hepatitis C Drug and explaining that the denial is based on your failure to have a specific level of hepatic fibrosis.
- An explanation of benefits (EOB) or other similar written documentation reflecting a denial of coverage for Harvoni or another Hepatitis C Drug and explaining that the denial is based on your failure to have a specific level of hepatic fibrosis.
Hepatitis C Insurance Settlement Notes
- Mark S. Shank, et al. v. Health Care Service Corporation, et al.
- Case No. 16-cv-03993
- Pending in the U.S. District Court for the Northern District of Illinois, Eastern Division
Plaintiff Mark Shank initiated this class action lawsuit alleging that Health Care Service Corporation (HCSC) wrongfully limited its policyholders coverage of the Hepatitis C drug Harvoni.
Harvoni is the brand name for the prescription drug consisting of ledipasvir and sofosbuvir in one pill and is currently approved by the FDA to treat chronic Hepatitis C.
Specifically, Shank says that HCSC breached its insurance contracts and violated various laws by applying a Fibrosis Restriction on its Prescription Drug Coverage Guidelines for Harvoni. A Fibrosis Restriction is a requirement in policyholders’ plans requiring an individual with Hepatitis C to demonstrate a specific level of hepatic fibrosis, or advanced liver scarring, in order to obtain prior authorization or approval for Harvoni.
HCSC denies any wrongdoing. The $200,000 settlement will be used to compensate Class members who submit valid and timely claims up to $2,676, unless the claims exceed $200,000, then the settlement will be divided pro rata (equal share) among eligible claimants. In addition to monetary compensation, HCSC has eliminated Fibrosis Restrictions from its Prescription Drug Coverage Guidelines for Harvoni for at least one year.
The settlement website further summarizes the terms of the settlement and how Class Members can file a claim. Complete details are provided in the Settlement Agreement. The Settlement Agreement and other related documents are available on the Hepatitis C Insurance Settlement website.
Class members who wish to exclude themselves or object to the terms of the Hepatitis C Insurance Class Action Settlement must do so by January 8, 2018. Class members who wish to submit a claim must do so by January 23, 2018.
- 1/23/18: Claim Form Deadline
- 1/8/18: Objection or Exclusion Deadline
- 3/20/18: Final Hearing at 9:00 am CST* (class members do not need to attend this hearing in order to receive a slice of the settlement pie).
*Settlement Class Members who wish to speak at the hearing should check www.hepatitiscinsurancesettlement.com to confirm that the date or time of the Hearing has not been changed.
- Mail: Shank v. HCSC Settlement Administrator, c/o Epiq Systems, P.O. Box 3775, Portland, OR 97208-3775
- Phone: 1-888-752-4075