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September 2014
Clinical Practice Management
IDSA, HIVMA Appeal Medicaid Restrictions on Who Treats HCV
In response to action taken by some state Medicaid programs to restrict the types of providers who can prescribe drug therapies to treat hepatitis C virus (HCV), IDSA and HIVMA have developed an appeals letter template recommending that infectious diseases specialists and other HIV providers be covered prescribers of all HCV medications.

The letter provides succinct evidence points as well as a link to IDSA/HIVMA’s appeals letter to the Center for Medicare and Medicaid Services (CMS), which expresses the rationale for inclusion of ID specialists and HIV providers in HCV medication coverage in further detail. Among other points, the letter notes that IDSA, in collaboration with the American Association for the Study of Liver Diseases, is leading the way in providing timely guidance on HCV to clinicians (see www.hcvguidelines.org). IDSA members can insert their contact information and send the personalized appeals letter to a pharmacy director urging for a change in coverage.

HIVMA also issued a statement along with the American Academy of HIV Medicine expressing concerns about these restrictions and the adverse effects on patient care.

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