LA HAP Bulletin for 6/12/18

Updated Hepatitis C coverage criteria for Medicaid recipients

Louisiana Medicaid has finalized updated guidance regarding coverage of Hepatitis C medications. Documentation of fibrosis staging is no longer a requirement for HIV/HCV coinfected individuals seeking treatment. Other documentation requirements remain in place, including attestation (but not full documentation) of 6-month abstention from substance/alcohol use. Full information on this policy, including MCO-specific guidelines, is located here.

Because these transitional periods often present challenges, LA HAP is not making any changes to our Medicaid/HCV program requirements until AT LEAST June 30th. Please keep us informed regarding any issues that you and your clients might experience navigating Medicaid’s prior authorization process for HCV coverage. This will help us inform our coverage policies going forward.

Annual Open Enrollment beginning for Medicaid

Open Enrollment for Medicaid (the “Healthy Louisiana” Expansion population) begins this Friday June 15th and runs until July 31st . While Medicaid has a continuous enrollment period for new members, existing members will have the opportunity to switch from one Managed Care Organization to another during this time. More details here.