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Removal of Quantity Limits for Hepatitis C Medications, Including Mavyret Preferred Hepatitis C Treatment

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On May 25, 2023, the Texas Health and Human Services Commission (HHSC) changed the quantity limit on direct-acting antiviral (DAA) drugs for treating hepatitis C. This change applies to all Medicaid clients in managed care and fee-for-service.

On January 1, 2023, HHSC selected Mavyret as the primary preferred DAA drug option for treating hepatitis C infection in Medicaid clients. Mavyret is the only DAA medication available to Medicaid clients without prior authorization. All Medicaid clients are eligible for hepatitis C virus DAA treatment without a prior authorization requirement for Mavyret, regardless of the client’s METAVIR fibrosis score. Any enrolled Medicaid provider can prescribe Mavyret, and HHSC does not require a drug screening.

HHSC allows prescribers to write prescriptions for the entire course of therapy for DAAs, and clients no longer need to request additional refills throughout their treatment duration. Prescribers may choose to write a prescription for the entire treatment cycle or have the client return for further testing if warranted. This change to the quantity limit applies to all hepatitis C DAA medications.

Refer to the Hepatitis C Treatment page to learn more.

Email vdp-operations@hhsc.state.tx.us with comments or questions.