Between February 2024 and August 2024:
- 1 more state (NM) removed prior authorization requirements.
- 2 states (AR, IA) removed substance use restrictions.
- 1 state (IA) removed prescriber restrictions.
- 1 state (IA) removed retreatment restrictions.
Overall Grades
A+ (19): Colorado, Delaware, District of Columbia, Idaho, Kansas, Michigan, Missouri, New Hampshire, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Virginia, Washington, Wisconsin
A (10): Alaska, Arizona, California, Connecticut, Hawaii, Illinois, Indiana, Louisiana, Massachusetts, South Dakota
B (13): Alabama, Florida, Iowa, Kentucky, Minnesota, Mississippi, Ohio, Puerto Rico, South Carolina, Tennessee, Vermont, Wyoming
C (11): Arkansas, Georgia, Maine, Maryland, Montana, Nebraska, Nevada, New Jersey, North Dakota, Utah, West Virginia
Citation: Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable, Hepatitis C: State of Medicaid Access (2024), www.stateofhepc.org
Prior Authorization Requirements
No Prior Authorization for Most Patients (29): Alaska, Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Kansas, Louisiana, Massachusetts, Michigan, Missouri, New Hampshire, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Virginia, Washington, Wisconsin
Prior Authorization Required (23): Alabama, Arkansas, Georgia, Iowa, Kentucky, Maine, Maryland, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Jersey, North Dakota, Ohio, Puerto Rico, South Carolina, South Dakota, Tennessee, Utah, Vermont, West Virginia, Wyoming
Citation: Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable, Hepatitis C: State of Medicaid Access (2024), www.stateofhepc.org
Fibrosis Restrictions
No Fibrosis Restrictions (52): Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, DC, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming
Citation: Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable, Hepatitis C: State of Medicaid Access (2024), www.stateofhepc.org
Sobriety Restrictions
No Substance Use Restriction (45): Alabama, Arizona, Arkansas, California, Colorado, Connecticut, District of Columbia, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, Wyoming
Provider Must Address and/or Counsel Patient About Substance Use Issues Prior to Treatment (7): Alaska, Minnesota, Mississippi, Montana, Nebraska, North Dakota, West Virginia
Citation: Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable, Hepatitis C: State of Medicaid Access (2024), www.stateofhepc.org
Prescriber Restrictions
No Prescriber Restrictions for Simplified Treatment (49): Alabama, Alaska, Arizona, California, Colorado, Connecticut, DC, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Louisiana, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming
Prescriber Restrictions (3): Arkansas, Illinois, Nevada
Citation: Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable, Hepatitis C: State of Medicaid Access (2024), www.stateofhepc.org
Retreatment Restrictions
No Retreatment Restrictions (39): Alaska, Arkansas, Colorado, Connecticut, District of Columbia, Delaware, Hawaii, Idaho, Illinois, Iowa, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Wisconsin
Retreatment Restrictions based on adherence, substance use, or SVR12 documentation (13): Alabama, Arizona, California, Florida, Georgia, Indiana, Kentucky, Maine, Maryland, Montana, North Dakota, West Virginia, Wyoming
Citation: Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable, Hepatitis C: State of Medicaid Access (2024), www.stateofhepc.org
Managed Care Restrictions
No Additional Restrictions in Managed Care (33): Arkansas, Arizona, California, Colorado, Delaware, District of Columbia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Hampshire, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Puerto Rico, Rhode Island, Tennessee, Texas, Virginia, Washington, West Virginia, Wisconsin
Additional Restrictions and/or Lack of Transparency in Managed Care (9): Florida, Georgia, Hawaii, Maryland, Nebraska, Nevada, New Jersey, South Carolina, Utah
N/A, State Doesn’t Contract with Managed Care (10): Alabama, Alaska, Connecticut, Idaho, Maine, Montana, Oklahoma, South Dakota, Vermont, Wyoming
Citation: Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable, Hepatitis C: State of Medicaid Access (2024), www.stateofhepc.org
Compare this snapshot
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