Centers for Medicare and Medicaid Services Urges States to Ensure Access to Curative Hepatitis C Treatment and Comply with Federal Medicaid Law

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Contact: Ryan Clary, National Viral Hepatitis Roundtable

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Centers for Medicare and Medicaid Services Urges States to Ensure Access to

Curative Hepatitis C Treatment and Comply with Federal Medicaid Law

NVHR Applauds Strong Guidance Supporting Increased Access to Cure

WASHINGTON, D.C., Thursday, November 5, 2015 – The Centers for Medicaid and Medicare Services (CMS) today released a critical program notice – “Assuring Medicaid Beneficiaries Access to Hepatitis C (HCV) Drugs” – providing guidance to state Medicaid programs regarding open access to revolutionary new curative treatments for the chronic, communicable, and potentially life-threatening condition.

“We are extremely gratified to see this strong guidance to state Medicaid programs regarding what NVHR considers highly discriminatory restrictions on access to hepatitis C curative therapy,” said Ryan Clary, Executive Director of the National Viral Hepatitis Roundtable (NVHR). “Some of the most egregious restrictions are directly counter to expert medical guidance on treating hepatitis C; we’re very excited to share this news and look forward to what we hope will be the beginning of more open access to the new treatment options the community has been eagerly awaiting.”

Before FDA approval of new direct-acting antivirals which began in 2014, the hepatitis C treatment landscape was bleak. Prior interferon-based treatments offered low cure rates, long regimens, and debilitating side effects. Many patients seeking treatment in the past were told by their doctors to wait for new medications, only to now be told they are not sick enough to qualify for treatment.

“To go from discovery to cure for an infectious viral condition in just 26 years is an astounding accomplishment, and we can realize the elimination of hepatitis C in the United States, but that requires widespread access to curative treatment,” said Clary. “Especially as we bear witness to a second wave of this epidemic coming on the heels of the opioid crisis, it is vital that the treatment of people with active substance use disorders be informed by evidence, not stigma or conjecture.”

The notice also highlights the discrepancies in access even within states between fee-for-service (FFS) programs and Medicaid managed care organizations (MCOs), with MCOs taking a much more restrictive approach. This was a critical aspect of coverage restrictions to address, as the healthcare landscape increasing moves toward an MCO model of care.

“We are very encouraged by this letter,” said Clary, “and look forward to continued work with CMS to support states in achieving our shared goals of broad access and quality care for our communities.”

About National Viral Hepatitis Roundtable (NVHR)

The National Viral Hepatitis Roundtable is a broad coalition working to fight, and ultimately end, the hepatitis B and hepatitis C epidemics. We seek an aggressive response from policymakers, public health officials, medical and health care providers, the media, and the general public through our advocacy, education, and technical assistance. Please visit us at