New Jersey

State of Hepatitis C
Medicaid Access:

A-

New Jersey

Liver damage restrictions

Fee-For-Service (FFS) and all Managed Care Organizations (MCOs) do not impose liver damage requirements.

Sobriety restrictions

FFS and all MCOs do not impose sobriety requirements.

Prescriber restrictions

FFS and four MCOs, Aetna, Horizon, UHC, and Wellcare, require a specialist to prescribe. One MCO, Amerigroup, does not impose prescriber restrictions.

Recommendations

  • Eliminate liver damage, sobriety and prescriber requirements.
  • Achieve hepatitis C coverage parity across FFS and MCO programs and provide transparency regarding hepatitis C coverage criteria.

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