On May 25, 2023, HHSC changed the quantity limit on direct-acting antiviral (DAA) drugs for treating Hepatitis C. This change applies to all Medicaid clients in managed care and fee-for-service.
On Jan. 1, 2023, HHSC selected Mavyret as the primary preferred DAA drug option for treating Hepatitis C infection in Medicaid patients. Mavyret is the only DAA medication available to Medicaid patients without prior authorization. HHSC partnered with AbbVie to work toward significantly reducing chronic Hepatitis C in Medicaid patients. All Medicaid clients are eligible for HCV DAA treatment without a prior authorization requirement for Mavyret, the primary preferred agent, regardless of the client’s METAVIR fibrosis score. Any enrolled Medicaid provider can prescribe Mavyret, and HHSC does not require a drug screening.
HHSC allows prescribers to write prescriptions for the entire course of therapy for DAAs, and clients no longer need to request additional refills throughout their treatment duration. Prescribers may choose to write a prescription for the entire treatment cycle or have the client return for further testing if warranted. This change to the quantity limit applies to all Hepatitis C DAA medications.
Refer to the Medicaid Hepatitis C Treatment Initiative page to learn more.