Nevada

Liver damage restrictions

Fee-For-Service (FFS) and one managed care organization (MCO), Anthem, do not impose liver damage restrictions. Two MCOs, Health Plan of Nevada and SilverSummit Healthplan, do not provide hepatitis C coverage criteria publicly. It is unclear whether one MCO, Molina, imposes liver damage restrictions.

Sobriety restrictions

FFS and two MCOs, Anthem and Molina, do not impose sobriety requirements. Two MCOs, Health Plan of Nevada and SilverSummit, do not provide hepatitis C coverage criteria publicly.

Prescriber restrictions

FFS and one MCO, Molina, require that a prescription be written by or in consultation with a specialist. One MCO, Anthem, does not impose prescriber requirements. Two MCOs, Health Plan of Nevada and SilverSummit Healthplan, do not provide hepatitis C coverage criteria publicly.

Recommendations

• Remove prescriber restrictions.
• Require MCOs to make their hepatitis C coverage criteria publicly available.