MedicaidAdministrativeMedium impact

Hepatitis C Virus (HCV) Retrospective Review Process

Q: Who is affected by this change?

This affects Maryland Medicaid Gastroenterology, Infectious Disease, Internal Medicine, Family Medicine providers in MD on Medicaid plans.

Maryland Medicaid·MD · Gastroenterology, Infectious Disease, Internal Medicine +1 more·Provider Transmittal

Effective date

Not stated

We identified it

Jun 20, 2026

Days to comply

—

Summary

Maryland Medicaid has implemented a new retrospective review process for Hepatitis C Virus (HCV) treatments. This affects billing and reimbursement procedures for HCV-related services, requiring additional documentation or review steps for claims processing.

Action Required

Action needed

Immediately: Review the full Maryland Medicaid Provider Transmittal PT 23-22 for specific HCV retrospective review requirements. Billing team must understand new documentation requirements and review processes for HCV treatment claims. Update billing workflows to accommodate retrospective review procedures for Maryland Medicaid patients receiving HCV treatments.

Related policy hubs

Maryland Medicaid policies MD policy changes Gastroenterology Infectious Disease Internal Medicine Family Medicine