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: