Rhode Island Improves Access to Hepatitis C Treatment for Medicaid Patients

The state removed prior authorizations for two preferred hepatitis C medications, increasing access to hepatitis C treatments for more Rhode Islanders. 

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The National Viral Hepatitis Roundtable (NVHR) and the Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) today applauded Rhode Island Medicaid for removing prior authorizations for two preferred treatments for hepatitis C, effective as of August 1, 2021. Rhode Island follows in the footsteps of just seven other states that do not require prior authorization for hepatitis C treatment, including California, Indiana, Louisiana, Michigan, New York, Washington, and Wisconsin. Nearly 23,000 Rhode Island residents are estimated to be living with hepatitis C. Removing prior authorizations will increase access to the hepatitis C cure for thousands of Medicaid beneficiaries living with hepatitis C.

“Prior authorizations are a modifiable barrier to hepatitis C elimination that limit access to treatment for marginalized communities. Rhode Island’s decision to remove these requirements for two preferred antiviral treatments will ultimately provide greater access to care for thousands of Rhode Island residents, and brings us closer to our goal of eliminating hepatitis C across the country,” said Adrienne Simmons, PharmD, MS, Director of Programs at NVHR. “Rhode Island joins a growing number of states who have recently taken the important step to remove prior authorizations for hepatitis C treatment, and we hope other states will continue to follow their lead.”

Cases of Hepatitis C, a viral infection that causes liver inflammation and is one of the leading causes of liver disease, have been increasing since 2010 due to the ongoing opioid crisis. Today’s treatment for hepatitis C can cure most people in 8 to 12 weeks. Yet barriers to this treatment persist across the country.

“I applaud Rhode Island Medicaid for removing prior authorization processes for two hepatitis C regimens. It was a collective effort that got us to this point, and a decision made in response to ongoing work from healthcare workers, people with lived experience, and advocacy coming together,” said Lynn E. Taylor, MD, FACP, FAASLD, Director of HIV and Viral Hepatitis Services at CODAC Behavioral Health. “While this is a game-changing step forward towards hepatitis C elimination, we must continue to break down remaining barriers and discriminatory practices. Prior authorizations for direct-acting antivirals needed for patients with contraindications to the two Medicaid-preferred treatments remain in place, as do prior authorizations and high copay costs for individuals with commercial insurance.” Taylor’s organization, a non-profit based in Cranston, RI, provides outpatient treatment for Opioid Use Disorder across seven community-based locations and programming at the Rhode Island Department of Corrections.

“It is encouraging to see Rhode Island follow the lead of numerous other states to remove prior authorization requirements for hepatitis C treatments patients,” said Phil Waters, Staff Attorney at CHLPI. “We encourage all payors and providers to immediately implement the new policies to help improve public health outcomes, especially amid the ongoing coronavirus pandemic.”

Prior authorization is a process whereby health care providers must get advance approval before a payor will decide whether to cover a medication or service. The latest removal of prior authorizations for two preferred hepatitis C treatments has consequently increased Rhode Island’s Hepatitis C: State of Medicaid Access score to A+. For more information about hepatitis C treatment access barriers, please visit www.stateofhepc.org. www.stateofhepc.org.