New Mexico

State of Hepatitis C
Medicaid Access:

A

New Mexico

Liver damage restrictions

New Mexico Fee-For-Service (FFS) and managed care organizations (MCOs) do not impose liver damage restrictions.

Sobriety restrictions

New Mexico FFS and MCOs do not impose sobriety restrictions.

Prescriber restrictions

New Mexico FFS and two MCOs, BlueCross BlueShield of New Mexico and Presbyterian Health Plan, do not impose prescriber restrictions. One MCO, Western Sky Community Care, requires that a prescription be written by or in consultation with a specialist.

Recommendations

  • Maintain open access and transparency regarding hepatitis C coverage requirements.
  • Ensure parity across FFS and MCO plans.
  • Remove prior authorization for patients who qualify for simplified treatment.

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