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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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