North Dakota

State of Hepatitis C
Medicaid Access:

C+

North Dakota

Liver damage restrictions

Fee-For-Service (FFS) and Primary Care Case Management (PCCM) do not impose liver damage restrictions. The Managed Care Organization (MCO), Sanford Health Plan, does not have publicly available hepatitis C coverage criteria.

Sobriety restrictions

FFS/PCCM require three months of abstinence from alcohol and injection drug use. The MCO, Sanford Health Plan, does not have publicly available hepatitis C coverage criteria.

Prescriber restrictions

FFS/PCCM require a prescription to be written by or in consultation with a specialist. The MCO, Sanford Health Plan, does not have publicly available hepatitis C coverage criteria.

Recommendations

  • Remove sobriety and prescriber requirements.
  • Ensure parity across FFS and MCO and transparency regarding hepatitis C coverage requirements.

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