Healthcare
Communicable diseases: hepatitis C
California bars prior authorization for medically necessary hepatitis C antiviral treatment in most commercial health coverage.
The law removes an insurer approval step that can delay access to direct-acting antiviral drugs used to treat hepatitis C.
What the law does
- Prohibits health care service plans and health insurers from requiring prior authorization for medically necessary direct-acting antiviral drugs to treat hepatitis C.
- Allows prior authorization for therapeutically equivalent versions of an FDA-approved pangenotypic hepatitis C treatment if at least one equivalent version is covered without prior authorization.
- Exempts Medi-Cal managed care contracts with the State Department of Health Care Services.
Who it affects
- People enrolled in covered health care service plans or health insurance who need medically necessary direct-acting antivirals for hepatitis C.
- Health care service plans and health insurers.