The Philadelphia Department of Public Health, Division of Disease Control is issuing this Health Notification to make clinical providers aware of the removal of restrictions to treat patients infected with hepatitis C virus (HCV). Medicaid patients with HCV infection and liver damage measured at a METAVIR liver fibrosis score greater than F0 are now covered for treatment in Pennsylvania. By January 1, 2018 there will be no liver fibrosis limitation for treatment of hepatitis C for Pennsylvania (PA) Medicaid patients.
In Philadelphia, an estimated 54,000 people are living with HCV. Of these, 53% are aware that they have been infected and 13% have been cured of the virus. The low rate of cure is due in large part to restrictions in coverage for safe and effective medications, including limiting treatment to patients with a METAVIR liver fibrosis score of F2 or greater (this scoring system ranges from F0, no liver damage, to F4, cirrhosis).
On May 16, 2017 the PA Department of Human Services announced long awaited changes to the state’s Medicaid policy regarding HCV treatment access. Over the course of the next year, major treatment access restrictions will be phased out in Pennsylvania. On July 1, 2017 HCV patients on Medicaid with METAVIR liver fibrosis scores greater than F0 were granted access to treatment with direct acting antivirals. On January 1, 2018 all restrictions to treatment based on liver fibrosis will be removed meaning patients will no longer need to wait for their disease severity to increase before they can be treated. There is still no sobriety requirement for HCV patients seeking care. This applies to both Fee For Service and Managed Care Organizations.
The following resources are available to support clinical practices in the implementation of expanded HCV treatment access:
– HCV Treatment Guidelines. The American Association for the Study of Liver Diseases offers guidance for all aspects of the HCV care continuum from testing to treatment. Access their recommendations at http://www.hcvguidelines.org/
– Join the Local HCV Community. The Hepatitis C Allies of Philadelphia (HepCAP) is a citywide collective dedicated to improving the continuum of hepatitis C prevention, diagnosis, care, and support services in Philadelphia. Join the conversation and meet the community at http://www.hepcap.org/
– Free HCV CME Opportunity. HepCAP has a continuing medical education opportunity for primary care practices that would like additional knowledge of hepatitis C. Free, one-hour training, by local hepatitis treatment specialists, covers screening guidelines and best practices for linking patients to care. To schedule a Hepatitis C for Primary Care Providers in-service, email [email protected] or call 215-246-5212.
– PDPH Educational Materials. Learn more about viral hepatitis. Download posters and other educational materials at: https://hip.phila.gov/DiseaseControlGuidance/DiseasesConditions/HepatitisC For hard copies, please contact the Viral Hepatitis Prevention Coordinator, Jack Hildick-Smith, at [email protected] or (215) 685-6462.
For additional information regarding viral hepatitis visit: www.phillyhepatitis.org
Originally released on July 17, 2017.