MedicaidAdministrativeMedium impact
Hepatitis C Virus (HCV) Retrospective Review Process, effective January 1, 2021
Maryland Medicaid·MD · Gastroenterology, Infectious Disease, Internal Medicine +1 more·Provider Transmittal
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has implemented a new Hepatitis C Virus (HCV) Retrospective Review Process effective January 1, 2021. This policy establishes a review process for HCV-related claims that may affect billing and reimbursement for hepatitis C treatments.
Action Required
Immediately: Review the full Maryland Medicaid Provider Transmittal PT 33-21 for specific HCV retrospective review requirements. Billing team must ensure compliance with new review process for all hepatitis C virus related claims. Document medical necessity and treatment protocols according to updated guidelines to avoid potential claim reviews or denials.