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NYS Medicaid Pharmacy Prior Authorization Programs

Hepatitis C Virus Agents

Hepatitis C Virus Agents

Prior Authorization Worksheets
Title
Title
Chronic Hepatitis C (CHC) Infection Check List for Prior Authorization Requests
Hepatitis C Worksheet

For Clinical information on HCV and use of these products, please visit the Prescriber Education program website.

For clinical concerns or questions, please call (877) 309-9493
For billing questions, please call (800) 343-9000
For Medicaid pharmacy policy and operation questions, please call (518) 486-3209