MedicaidCoverageMedium impact
Directing Acting Antiviral (DAA) Coverage
Maryland Medicaid·MD · Gastroenterology, Infectious Disease, Internal Medicine·Provider Transmittal
We identified it
Jun 20, 2026
Summary
This policy establishes coverage for Direct Acting Antiviral (DAA) medications for Hepatitis C treatment under Maryland Medicaid managed care plans. The policy outlines specific criteria for coverage including genotype requirements, treatment duration, and prior authorization processes.
Action Required
Review current Hepatitis C treatment protocols and ensure prior authorization requests for DAA medications include required documentation such as HCV genotype, viral load, and treatment history. Verify billing processes align with Maryland Medicaid coverage criteria for these high-cost specialty medications.