CCPEC Hepatitis C Medications

Hepatitis C Medications

Program for submitting Prior-Approval (PA) requests for Hepatitis C medications through NCTracks.

    • A PA form must be submitted through the NCTracks Web Portal; pharmacy authorization forms can be found here.
    • PA for Hepatitis C medications requires the provider to also submit medical records and documentation of the chronic Hepatitis C diagnosis, with genotype and subtype, if available.
    • Specific drug requirements and necessary documentation are outlined here: