Arizona

State of Hepatitis C
Medicaid Access:

C+

Arizona

LIVER DAMAGE RESTRICTIONS

Fee-For-Service (FFS) and five Managed Care Organizations (MCOs), Health Choice, Health Net, Care 1st, Mercy Care, and UHC, require a diagnosis of chronic hepatitis C to access treatment. One MCO, University Family Care, does not have publicly available hepatitis C coverage criteria.

SOBRIETY RESTRICTIONS

FFS and five MCOs, Health Choice, Health Net, Care 1st, Mercy Care, and UHC, require beneficiaries to be “in remission” for the past three months from the request date of treatment, and those who have had “a substance use disorder within the past 12 months” must engage in a treatment program. One MCO, University Family Care, does not have publicly available hepatitis C coverage criteria.

PRESCRIBER RESTRICTIONS

Arizona FFS and four MCOs, Health Choice, Health Net, Care 1st, and Mercy Care, require a prescription to be written by or in consultation with a hepatologist, gastroenterologist, or infectious disease specialist. One MCO, UnitedHealthcare Community Plan, requires a specialist to prescribe. One MCO, University Family Care, does not have publicly available hepatitis C coverage criteria.

RECOMMENDATIONS

  • Remove sobriety and prescriber requirements.
  • Improve transparency regarding hepatitis C coverage criteria and ensure parity across FFS and MCO plans.

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