Florida let hepatitis C go untreated in prisons. Now it may cost taxpayers millions.

The state of Florida may have to pay hundreds of millions of dollars in treatment costs to as many as 20,000 sick inmates after a federal judge ruled Friday that prison officials had failed to properly care for felons infected with the hepatitis C virus.

The ruling, by U.S. District Court Judge Mark Walker, requires the Florida Department of Corrections to immediately treat a significant portion of the state’s 98,000 inmates who test positive for the viral infection with direct acting antiviral drugs, a 12-week treatment that now costs about $37,000 per patient.

“FDC has a long and sordid history of failing to treat HCV-infected inmates,” Walker wrote in his 32-page ruling. “And this court finds as a matter of fact that FDC’s failure to treat was due to a lack of funding.”

The class action lawsuit was filed in May by three inmates who have been suffering for years from the ravages of hepatitis C but were denied treatment from both the state and the private companies contracted to provide medical care in the prison system.

Walker said the state was “deliberately indifferent to the serious medical needs” and noted that only 13 inmates of the more than 7,000 eligible had ever been given the antiviral drugs, and three of them were given treatment after being named plaintiffs in the case.

 “If these inmates are not treated, they will undoubtedly suffer irreparable injury,” Walker wrote. “Although DAAs [direct acting antivirals] can cure a person of HCV, they do not necessarily reduce the level of fibrosis a person has already suffered. … Consequently, it is important to treat patients with HCV as soon as possible so that they can be cured of the virus before their liver becomes significantly diseased.”

He ordered the department to “move with alacrity” and said the court “will not tolerate further foot dragging.” He then gave the agency until Dec. 1 to develop a plan and ordered that it treat the most severe cases first.

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