Online PA Submission Available for Hepatitis C Drugs Mavyret and Vosevi

Beginning August 26, 2018, prior approval (PA) requests for Hepatitis C drugs Mavyret (glecaprevir and pibrentasvir) and Vosevi can be submitted online using the secure NCTracks provider portal. Instructions for submitting a pharmacy PA on the portal can be found in the PA 341_Prior Approval Medical Participant User Guide in SkillPort.

Mavyret and Vosevi are covered by Medicaid when a recipient is 18 years of age or older and has a diagnosis of chronic hepatitis C (CHC) with confirmed genotype 1, 2, 3, 4, 5, or genotype 6 without cirrhosis or with compensated cirrhosis (Child-Pugh A) and meets the other criteria for coverage. The full clinical coverage criteria for Hepatitis C medications, including Mavyret and Vosevi, are on the Prior Approval Drugs and Criteria page of the portal.

PA requests for Mavyret and Vosevi may still be submitted on paper forms, located on the Drug Request Forms page of the portal. However, providers are encouraged to submit PA requests online to expedite the review and disposition of the PA request.