MedicaidPrior AuthMedium impact
2023.64 Provider Bulletin - New Hepatitis C Policy pdf
Connecticut Medicaid (HUSKY Health)·CT · Gastroenterology, Infectious Disease, Internal Medicine +1 more·Provider Bulletin
Effective date
Nov 1, 2023
We identified it
Jun 20, 2026
Summary
Starting November 1, 2023, Connecticut Medicaid is eliminating prior authorization requirements for NEW Hepatitis C therapy. However, prior auth will still be required if patients exceed therapy duration or show non-compliance gaps, triggering Edit 3022.
Action Required
By November 1, 2023: Billing team must update system to remove prior authorization requirements for NEW Hepatitis C medications for Connecticut Medicaid patients. Configure alerts for Edit 3022 (NCPDP response code 75) which will require medical necessity letters faxed to 860-424-4822 or emailed to rx.lmn@ct.gov when therapy duration is exceeded or non-compliance detected. Verify non-preferred Hepatitis C drugs still require PDL prior authorization.