OIG Finds Few Medicaid Hepatitis C Patients Treated Within Six Months
HHS Office of Inspector General reports that fewer than 25 percent of Medicaid beneficiaries diagnosed with hepatitis C received treatment within six months of diagnosis. The report examines barriers to timely access to direct-acting antiviral medications for Medicaid enrollees, a population with disproportionately high hepatitis C prevalence. OIG's findings point to gaps in state Medicaid programs' and managed care plans' utilization management practices, including prior authorization requirements and restrictions tied to sobriety or disease staging that have previously been flagged as limiting access. The report is likely to inform calls for states to loosen treatment restrictions and for CMS to issue further guidance on access standards.