Arizona

State of Hepatitis C
Medicaid Access:

B

Arizona

LIVER DAMAGE RESTRICTIONS

Fee-For-Service (FFS) and six managed care organizations (MCOs), Arizona Complete Health, Banner-University Family Care, Molina, Mercy Care, Health Choice Arizona, and United Healthcare Community Plan, do not impose liver damage restrictions. One MCO, Care1st, does not publish hepatitis C coverage criteria.

SOBRIETY RESTRICTIONS

FFS and five MCOs, Banner-University Family Care, Molina, Mercy Care, Health Choice Arizona, and UnitedHealthcare Community Plan do not impose sobriety restrictions. One MCO, Arizona Complete Health, requires three months sobriety from the request date of treatment. One MCO, Care1st, does not publish hepatitis C coverage criteria.

PRESCRIBER RESTRICTIONS

FFS and six MCOs (Arizona Complete Health, Banner-University Family Care, Molina, Mercy Care, Health Choice Arizona, and United Healthcare Community Plan) require a prescription to be written by or in consultation with a gastroenterologist, hepatologist, or infectious disease physician. One MCO, Care1st, does not publish hepatitis C coverage criteria.

RECOMMENDATIONS

  • Remove prescriber requirements.
  • Ensure parity across FFS and MCO plans and transparency about hepatitis C coverage criteria.

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