Mealey's (June 23, 2016, 2:10 PM EDT) -- FORT PIERCE, Fla. — A Florida federal judge on June 21 approved an unopposed motion for preliminary approval of a settlement worth at least $126 million in an Employee Retirement Income Security Act class action against Blue Cross and Blue Shield of Florida Inc. on behalf of patients denied coverage for the prescription drug Harvoni (Eugene Oakes, et al. v. Blue Cross and Blue Shield of Florida Inc., No. 16-80028, SD. Fla.).
(Order available. Document #54-160713-035R.)
Plaintiffs Eugene Oakes, Keith Burt and Debbie Harris, on behalf of themselves and settlement class members, allege that Blue Cross and Blue Shield of Florida (Florida Blue) violated the law by applying its medical coverage guidelines for hepatitis C drug therapy for requests for coverage of Harvoni that, in most circumstances, limited coverage of Harvoni to persons with advanced liver scarring. Florida Blue denies any wrongdoing
U.S. Judge Robin L. Rosenberg of the Southern District of Florida said Florida Blue did not oppose the motion filed by Oakes, Burt and Harris, who have been designated as representatives of the settlement class.
“The parties and their attorneys think the Settlement is fair, reasonable, and in the best interest of all Settlement Class Members,” Judge Rosenberg wrote.
Class Members
Judge Rosenberg preliminarily certified a settlement class that includes two subclasses.
The ERISA class is defined as all persons currently or formerly covered under any type of health benefits plan, health insurance policy or health maintenance organization contract governed by ERISA and insured or administered by Florida Blue whose request for authorization or coverage of Harvoni was denied on or before seven days before to the notice deadline.
The contract class is defined as all persons currently or formerly covered under any type of health benefits plan, health insurance policy or health maintenance organization contract not governed by ERISA and insured or administered by Florida Blue whose request for authorization or coverage of Harvoni was denied on or before seven days before to the notice deadline.
Anyone wanting to be excluded from the settlement class must mail a written request postmarked no later than the opt-out and objection deadline of Aug. 5 to settlement administrator Kurzman Carson Consultants, which has offices in California and New York. A final approval hearing is set for Aug. 26 at the District Court in West Palm Beach, Fla.
‘Life-Saving Cure’
In the plaintiffs’ June 16 unopposed motion for preliminary settlement approval, they say that after “a year of hard-fought litigation,” the parties have negotiated a settlement that will expand coverage for treatment with the “breakthrough drug” Harvoni — a “life-saving cure for hepatitis C” — to up to approximately 2,000 people suffering from hepatitis C, a retail value of about $126 million.
(Unopposed motion for preliminary settlement available. Document #54-160713-036M.)
As part of the settlement, Florida Blue has agreed to drop fibrosis restrictions for Florida Blue health insurance plan enrollees who might have been deterred from seeking Harvoni treatment by the restrictions. Florida Blue has also agreed to pay and not object to a motion by class counsel for an award of attorney fees and expenses of $2.24 million to class counsel.
The plaintiffs are represented by Andrés Rivero, Alan H. Rolnick, Jorge A. Mestre and Charles E. Whorton of Rivero Mestre in Miami, which has been designated as class counsel. Florida Blue is represented by Justin Brian Uhlemann, Marcos Daniel Jimenez and Robert Michael Kline of McDermott Will & Emory in Miami.
(Additional documents available. Amended complaint. Document #54-160713-037C. Motion to certify class. Document #54-160713-038M.)...