2019-31: Hepatitis C Virus DAA Agent Update

Date: 07/01/19

Effective July 15, 2019, the Louisiana Medicaid Fee for Service (FFS) Pharmacy program will update policies for pharmacy claims for Hepatitis C Virus Direct Acting Antiviral (DAA) agents. The preferred Hepatitis C Virus DAA agent will be sofosbuvir/velpatasvir (authorized generic AG) and will process at Point of Sale (POS) without prior authorization (PA). Pharmacy claims for non-preferred Hepatitis C Virus DAA agents will require prior authorization. 

Providers can refer to Louisiana Medicaid Single PDL (Fee For Service and Managed Care Organizations) (PDF)External Link on or after July 15, 2019, for information on the Hepatitis C Virus treatment policy and forms.

Pharmacy claims submitted by Medicaid 340B pharmacies for Hepatitis C Virus DAA agents will deny. All other 340B pharmacy claims will process as usual.
For questions related to pharmacy claims billing, contact the CVS Caremark help desk at 1-800-311-0543.

Please refer to Louisiana Department of Health memo (PDF) for additional information.