California has removed prior authorization requirements for medically necessary direct-acting antiviral drugs used to treat hepatitis C.
Gov. Gavin Newsom signed the legislation Sept. 27. It bars health care service plans and health insurers from subjecting medically necessary direct-acting antiviral drugs for hepatitis C to prior authorization.
An exception applies when the FDA has approved one or more therapeutic equivalents of a pangenotypic drug, device or product. Plans and insurers do not have to cover every therapeutically equivalent version without prior authorization if at least one pangenotypic and therapeutically equivalent version is covered without prior authorization.
The health care service plan provision does not apply to specified Medi-Cal managed care contracts with the State Department of Health Care Services.
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