2024 National Snapshot Report

A+ (19): Colorado, Delaware, District of Columbia, Idaho, Kansas, Michigan, Missouri, New Hampshire, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Virginia, Washington, Wisconsin

A (10): Alaska, Arizona, California, Connecticut, Hawaii, Illinois, Indiana, Louisiana, Massachusetts, South Dakota

B (13): Alabama, Florida, Iowa, Kentucky, Minnesota, Mississippi, Ohio, Puerto Rico, South Carolina, Tennessee, Vermont, Wyoming

C (11): Arkansas, Georgia, Maine, Maryland, Montana, Nebraska, Nevada, New Jersey, North Dakota, Utah, West Virginia

Citation: Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable, Hepatitis C: State of Medicaid Access (2024), www.stateofhepc.org

Prior Authorization Requirements

No Prior Authorization for Most Patients (29): Alaska, Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Kansas, Louisiana, Massachusetts, Michigan, Missouri, New Hampshire, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Virginia, Washington, Wisconsin

Prior Authorization Required (23): Alabama, Arkansas, Georgia, Iowa, Kentucky, Maine, Maryland, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Jersey, North Dakota, Ohio, Puerto Rico, South Carolina, South Dakota, Tennessee, Utah, Vermont, West Virginia, Wyoming

Citation: Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable, Hepatitis C: State of Medicaid Access (2024), www.stateofhepc.org

Fibrosis Restrictions

No Fibrosis Restrictions (52): Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, DC, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming

Citation: Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable, Hepatitis C: State of Medicaid Access (2024), www.stateofhepc.org

Sobriety Restrictions

No Substance Use Restriction (45): Alabama, Arizona, Arkansas, California, Colorado, Connecticut, District of Columbia, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, Wyoming

Provider Must Address and/or Counsel Patient About Substance Use Issues Prior to Treatment (7): Alaska, Minnesota, Mississippi, Montana, Nebraska, North Dakota, West Virginia

Citation: Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable, Hepatitis C: State of Medicaid Access (2024), www.stateofhepc.org

Prescriber Restrictions

No Prescriber Restrictions for Simplified Treatment (49): Alabama, Alaska, Arizona, California, Colorado, Connecticut, DC, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Louisiana, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming

Prescriber Restrictions (3): Arkansas, Illinois, Nevada

Citation: Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable, Hepatitis C: State of Medicaid Access (2024), www.stateofhepc.org

Retreatment Restrictions

No Retreatment Restrictions (39): Alaska, Arkansas, Colorado, Connecticut, District of Columbia, Delaware, Hawaii, Idaho, Illinois, Iowa, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Wisconsin

Retreatment Restrictions based on adherence, substance use, or SVR12 documentation (13): Alabama, Arizona, California, Florida, Georgia, Indiana, Kentucky, Maine, Maryland, Montana, North Dakota, West Virginia, Wyoming

Citation: Center for Health Law and Policy Innovation & National Viral Hepatitis Roundtable, Hepatitis C: State of Medicaid Access (2024), www.stateofhepc.org

Managed Care Restrictions

No Additional Restrictions in Managed Care (33): Arkansas, Arizona, California, Colorado, Delaware, District of Columbia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Hampshire, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Puerto Rico, Rhode Island, Tennessee, Texas, Virginia, Washington, West Virginia, Wisconsin

Additional Restrictions and/or Lack of Transparency in Managed Care (9): Florida, Georgia, Hawaii, Maryland, Nebraska, Nevada, New Jersey, South Carolina, Utah

N/A, State Doesn’t Contract with Managed Care (10): Alabama, Alaska, Connecticut, Idaho, Maine, Montana, Oklahoma, South Dakota, Vermont, Wyoming