The Obama Administration has released a letter, through the Centers for Medicare and Medicaid Services (CMS), calling on states to stop imposing conditions for coverage of Hep C medications that may unreasonably restrict access.  The letter also expresses concern “that in many states, Medicaid managed care organizations (MCOs) or other managed care arrangements’ conditions for payment for DAA HCV drugs appear to be more restrictive than coverage under the states’ fee-for-service (FFS) programs.”  The letter goes on to say that “drugs under the approved state plan must be available to individuals enrolled in Medicaid managed care arrangements.”
The letter concludes that “CMS shares with states the common goal of ensuring access to quality care for Medicaid beneficiaries. Given the complexities that have arisen with the introduction of the DAA HCV drugs, CMS will continue to work with State Medicaid agencies to continue providing and improving care to persons infected with chronic HCV infections.”

Read the full letter here

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