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Fee-For-Service (FFS) and two managed care organizations (MCOs), First Choice, and Healthy Blue, do not impose liver damage requirements. Three MCOs, Absolute Total Care, Humana Healthy Horizons, and Molina Healthcare, do not make hepatitis C coverage criteria publicly available.
FFS appears to require six months’ abstinence from alcohol and substances. First Choice requires the provider to attest that they have provided substance use counseling and offered referral for substance use disorder treatment. Healthy Blue does not appear to impose sobriety restrictions. Three MCOs, Absolute Total Care, Humana Healthy Horizons, and Molina Healthcare, do not make hepatitis C coverage criteria publicly available.
FFS appears to require that treatment be prescribed by or in consultation with a gastroenterology, infectious disease, or hepatology specialist. First Choice requires treatment to be prescribed by a specialist. Healthy Blue does not appear to impose prescriber restrictions. Three MCOs, Absolute Total Care, Humana Healthy Horizons, and Molina Healthcare, do not make hepatitis C coverage criteria publicly available.
Join us in urging officials across the country to support policies that help Americans living with hepatitis C get cured.
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@2022 HEPATITIS C: STATE OF MEDICAID ACCESS