In October 2020, NYS Fee for Service Medicaid removed prior authorizations for first time direct acting antivirals (DAAs) treatment of hepatitis C infection and for re-treatment within one year for any reason.
Prior authorizations remain in place for patients needing retreatment after one year, whether for treatment failure or reinfection.
Follow up is needed to ensure all Medicaid Managed Care Organizations implement the new policy, and to remove any existing prior authorizations from commercial insurance plans.
See Medicaid Drug Utilization Review Board notes with this announcement here (p. 5).
See FAQs here.