CommercialPrior AuthMedium impact
Chronic Hepatitis C (HCV)
Blue Cross & Blue Shield of Mississippi·MS · Gastroenterology, Infectious Disease, Internal Medicine +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their Chronic Hepatitis C treatment policy requiring prior authorization for all HCV medications including Epclusa, Harvoni, Mavyret, Sovaldi, Vosevi, and Zepatier. The policy requires extensive documentation including HCV RNA levels, genotype, lab work, cirrhosis assessment, and prescribing by board-certified specialists.
Action Required
Immediately: Billing team must verify prior authorization requirements for all Hepatitis C medications (Epclusa, Harvoni, Mavyret, Sovaldi, Vosevi, Zepatier, Pegasys, Ribavirin) for BCBS Mississippi patients. Providers must obtain prior auth with required documentation including HCV RNA levels, genotype, CBC, hepatic function panel, eGFR, INR, cirrhosis assessment, and prior treatment history. Ensure prescribing physician is board-certified gastroenterologist, infectious disease specialist, or transplant hepatologist. Claims without prior authorization will be denied.