Zepatier denials in California external review

In the California DMHC record, independent physician reviewers decided 110 published external-review cases involving Zepatierand overturned the plan’s denial in 84.5%. That is a historical result among cases that reached this program, not a forecast for an individual appeal.

California DMHC decisions
110
2016–2019
Overturned
84.5%
93 denials reversed

By condition

Published outcomes when Zepatier was denied for these conditions.
ConditionDecisionsOverturned
Hepatitis C49
85.7%
Hepatitis C Virus36
80.6%
Typical time to a decision
15 days
Most land between 10 and 19 days
Handled as urgent
13.6%
Expedited when a delay would cause harm

What the reviewers wrote

Excerpts from the independent reviewers’ published findings — the actual reasoning, quoted, not summarised.

Where the denial was overturned

Nature of Statutory Criteria/Case Summary: An enrollee has requested authorization and coverage for Zepatier 50/100 mg one tablet by mouth for 16 weeks and Ribasphere 200 mg three tablets by mouth every morning and two tablets every evening for 16 weeks for treatment of the enrollee’s hepatitis C virus. Findings: The physician reviewer found that according to the recent joint guidelines issued by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA), all patients with chronic hepatitis C should be treated except those with limited life expectancy due to non-liver-related conditions. This recommendation applies to all patients, regardless of fibrosis stage.
Medical Necessity · 2017 · IMR MN17-26689
Nature of Statutory Criteria/Case Summary: The enrollee has requested authorization and coverage for Zepatier 50/100 for 12 weeks for treatment of the enrollee’s chronic hepatitis C virus (HCV) genotype 1a. Findings: The physician reviewer found that the most recent joint guidelines issued by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA), all patients with chronic hepatitis C should be treated except those with limited life expectancy due to non-liver-related conditions. This recommendation applies to all patients, regardless of fibrosis stage. The guidelines recommend that treatment naïve genotype 1a patients should be treated with regimens including or Zepatier for 12 weeks when NS5A resistance is not found.
Medical Necessity · 2017 · IMR MN17-26433

Where the denial was upheld

Worth reading too — these show what an appeal has to overcome.
Nature of Statutory Criteria/Case Summary: An enrollee has requested Zepatier and ribavirin for treatment of his hepatitis C virus. Findings: The physician reviewer found that according to the joint guidelines issued by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA), all patients with chronic hepatitis C should be treated except those with limited life expectancy due to non-liver-related conditions. Per guidelines, patients with HIV co-infection are high priority for treatment.
Medical Necessity · 2016 · IMR MN16-22050
Nature of Statutory Criteria/Case Summary: A female enrollee has requested authorization and coverage for Zepatier 50-100 mg tablets for 12 weeks for treatment of the enrollee’s hepatitis C. Findings: The physician reviewer found that according to the most recent joint guidelines issued by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA), all patients with chronic hepatitis C should be treated, except those with limited life expectancy due to non-liver-related conditions. This recommendation applies to all patients, regardless of fibrosis stage. The guidelines recommend that treatment-naive, genotype 1a patients should be treated with regimens including Zepatier with ribavirin for 16 weeks when NS5A resistance is present.
Medical Necessity · 2017 · IMR MN17-26252

Figures and quotations on this page come from 42,749 published decisions in the California DMHC Independent Medical Review dataset. These are California external-review outcomes. Other state and federal programs have different eligibility rules, processes, and current availability; the rates here do not transfer to those programs or predict an individual result. Excerpts are quoted verbatim from the public record and describe this treatment generally, not any individual case.

How to use this in your appeal

These outcomes describe eligible cases completed through California DMHC’s Independent Medical Review program. They do not estimate the chance that an internal appeal, an external review in another jurisdiction, or your individual case will succeed. Use the record to identify evidence patterns involving Zepatier, then check the rights and deadlines that apply to your plan.

SOURCE: CALIFORNIA DMHC INDEPENDENT MEDICAL REVIEW OUTCOMES (CHHS OPEN DATA) · AGGREGATES + DEIDENTIFIED DECISION EXCERPTS/REFERENCE IDS · METHODOLOGY

Not legal or medical advice. Coverage Rights is a self-help tool that helps you prepare your own appeal. For advice about your specific situation, talk to a licensed attorney or your doctor.

Denied Zepatier? Use the California record to prepare.

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