The Center for Medicare Advocacy and Florida Health Justice Project Sue to Obtain “Off-label” Part D Prescription Drug Coverage for BeneficiaryPosted in Article
On April 6, 2018 the Center for Medicare Advocacy and Florida Health Justice Project filed a lawsuit in U.S. District Court for the Southern District of Florida on behalf of a 49-year-old beneficiary seeking Medicare coverage for his “off-label” (non-FDA-approved) use of a critically needed medication (Dobson v. Azar, 4:18-cv-10038-JLK). The beneficiary’s Medicare Part D plan denied coverage of the only medication that he and his doctor have found to control his debilitating symptoms. However, the denial was based on an overly restrictive interpretation of what counts as a “medically accepted indication” under the law. After exhausting Medicare’s appeal system, the beneficiary is now seeking help in federal court as his only hope to receive this critically important and medically necessary treatment.