New York*

State of Hepatitis C
Medicaid Access:

A-

New York*

Liver damage (Fibrosis) restrictions

New York FFS and MCOs does not impose liver damage restrictions.

Sobriety restrictions

New York FFS and MCOs do not impose sobriety restrictions.

Prescriber restrictions

New York FFS does not impose prescriber restrictions. Two MCOs, VNSNY Choice Health Plans and MetroPlus Health Plan, require a prescription to be written by or in consultation with a relevant specialist of HCV treatment-experienced provider.

Recommendations

  • Maintain parity between MCOs and FFS.
  • Remove the requirement of prior authorization for patients seeking retreatment.

*New York FFS does not require prior authorization for treatment naïve individuals.

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