[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-283749-105":53,"doc-detail-283749-en":119},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":112,"head_meta":114,"extra_data":116,"updated_unix":118},105,"en","pennsylvania-recommendations-to-improve-patient-access","Pennsylvania - Recommendations to Improve Patient Access","","Pennsylvania Medicaid coverage for hepatitis C is assessed as Grade A, with a total score of 92 based on policy deductions. The analysis identifies one major barrier: prior authorization is required for all direct-acting antiviral (DAA) HCV treatment regimens, resulting in a deduction of -8. The state imposes no restrictions on fibrosis level, substance use, prescriber eligibility, retreatment, or additional limits. Managed care organizations are reported to apply the same requirements as fee-for-service.",{"@graph":63,"@context":111},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/pennsylvania-recommendations-to-improve-patient-access/283749/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/pennsylvania-recommendations-to-improve-patient-access/283749.png","ImageObject",442,249,{"name":88,"@type":89},"Mia  ","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-31","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",6,{"@type":103,"mainEntity":104},"FAQPage",[105],{"name":106,"@type":107,"acceptedAnswer":108},"Does Pennsylvania Medicaid impose restrictions on fibrosis level, substance use, prescriber, or retreatment?","Question",{"text":109,"@type":110},"No—Pennsylvania Medicaid does not impose fibrosis restrictions, substance use restrictions, prescriber restrictions, or retreatment restrictions, and managed care organizations follow the same requirements as fee-for-service.","Answer","https://schema.org",{"og:url":78,"og:type":113,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":115,"canonical":78},"index,follow",{"doc_id":117,"site_id":56},283749,1792220634,{"code":4,"msg":5,"data":120},{"doc_id":117,"user_id":121,"nickname":88,"user_avatar":122,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":123,"file_id":124,"file_url":125,"file_type":126,"file_size":127,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":128,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":129,"faqs":130,"seo_title":131,"seo_description":61,"update_tm":132,"read_time":9},687207024478,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Pennsylvania  \n| Grade |  | Recommendations to Improve Patient Access |\n| --- | --- | --- |\n| A | 􀁸 | Remove prior authorization for HCV treatment. |\n\nState Overview  \nAs of February 2022, 3,510,718 individuals were enrolled in Medicaid and CHIP.1 It is estimated that as of 2016, 93,900 people were living with HCV in Pennsylvania.2 Pennsylvania Medicaid contracts with eight managed care organizations (MCOs): Aetna, Health Partners, Keystone First, UnitedHealthcare Community Plan, Gateway, UPMC, AmeriHealth, and Geisinger.3  \nThe Pennsylvania Medicaid Preferred Drug List includes Mavyret, sofosbuvir/velpatasvir, and Zepatier.4  \n\n| Deductions |  | Policy |  |\n| --- | --- | --- | --- |\n| Prior\u003Cbr>Authorization | -8 | Prior authorization is required for all Direct-Acting Antiviral (DAA) HCV treatment regimens.5 |  |\n| Fibrosis Restrictions |  | Pennsylvania Medicaid does not impose fibrosis restrictions.6 |  |\n| Substance Use Restrictions |  | Pennsylvania Medicaid does not impose substance use restrictions.7 |  |\n| Prescriber Restrictions |  | Pennsylvania Medicaid does not impose prescriber restrictions.8 |  |\n| Retreatment\u003Cbr>Restrictions |  | Pennsylvania Medicaid does not impose retreatment restrictions.9 |  |\n| Access in Managed Care |  | Aetna,10 Health Partners,11 Keystone First,12 UnitedHealthcare Community Plan,13 Gateway,14 UPMC,15 AmeriHealth,16 and Geisinger17 impose the same requirements as FFS. |  |\n| Additional Restrictions |  | Pennsylvania Medicaid does not impose additional restrictions.18 |  |\n| Total Deductions\u003Cbr>-8 |  | Total Score [100-Deductions]\u003Cbr>92 | Grade\u003Cbr>A |\n\nContact Your State Officials  \nMedicaid Office19 : Sally Kozak, Deputy Secretary, Office of Medical Assistance Programs, Pennsylvania Department of Human Services  \n625 Forster Street, Room 515, Harrisburg, PA 17120; Telephone: (717) 787‐2600; Email Address: [sakozak@pa.gov](sakozak@pa.gov)  \n[Pharmacy & Therapeutics Committee](Pharmacy & Therapeutics Committee20 : Terri Cathers)[20](Pharmacy & Therapeutics Committee20 : Terri Cathers)[ : Terri Cathers](Pharmacy & Therapeutics Committee20 : Terri Cathers), [Director of Pharmacy](Director of Pharmacy), Pennsylvania Department of Human Services 625 Forster Street, Harrisburg, PA 17120; Telephone: 1-800-537-8862  \nKey Sources  \nPreferred Drug List: Pennsylvania Department of Human Services, Statewide Preferred Drug List (PDL) (Jan. 2022) . Prior Authorization Form: Pennsylvania Department of Human Services, Hep. C Prior Authorization Form (Jan. 2022) . Aetna Prior Authorization Form: Aetna Better Health, Hepatitis C Agents Prior Authorization Form (Jan. 2022) .  \nHealth Partners Prior Authorization Form: Health Partners Plans, Hepatitis C Agents Prior Authorization Form (Jan. 2022) . Keystone First Prior Authorization Form: Keystone First, Hepatitis C Agents Prior Authorization Form (Jan. 2022) . UnitedHealthcare Prior Authorization Form: United Health Care, Hepatitis C Medications-Pennsylvania Prior Authorizations Form (Jan. 2022) .  \nGateway Health Plan Clinical Criteria: Gateway Health Plan, Medicaid Medication Policies (Jan. 2022) .  \nUPMC Prior Authorization Form: UPMC, Prior Authorization Form Hepatitis C (Aug. 2021) .  \nAmeriHealth Prior Authorization Form: AmeriHealth Caritas Pennsylvania, Hepatitis C Agents Prior Authorization Form (Jan. 2022) .  \nGeisinger Prior Authorization Form: GHP Family Pharmacy Customer Service, Hepatitis C Agents Prior Authorization Form (Jan. 2022) .    \n1 Centers for Medicare & Medicaid Services, Medicaid & CHIP in Pennsylvania: [https://perma.cc/P3HA-UT9N](https://perma.cc/P3HA-UT9N).  \n2 HepVu, Local Data: Pennsylvania (Jan. 2022): [https://perma.cc/E6RN-A67S](https://perma.cc/E6RN-A67S).  \n3 Preferred Drug List.  \n4 Preferred Drug List.  \n5 Preferred Drug List.  \n6 Prior Authorization Form.  \n7 Prior Authorization Form.  \n8 Prior Authorization Form.  \n9 Prior Authorization Form.  \n10 Aetna Prior Authorization Form.  \n11 Health Partners Prior Authorization","cbCaipcfzgUiNIYi","https://ap.wps.com/l/cbCaipcfzgUiNIYi","pdf",356250,"English","# State Overview\n# Policy Deductions\n## Prior Authorization\n## Fibrosis, Substance Use, Prescriber, and Retreatment Restrictions\n## Access in Managed Care\n# Contact Your State Officials\n# Key Sources","[{\"question\":\"Does Pennsylvania Medicaid impose restrictions on fibrosis level, substance use, prescriber, or retreatment?\",\"answer\":\"No—Pennsylvania Medicaid does not impose fibrosis restrictions, substance use restrictions, prescriber restrictions, or retreatment restrictions, and managed care organizations follow the same requirements as fee-for-service.\"}]","Pennsylvania - Recommendations to Improve Patient Access | PDF",1789618708]