< 25% of Medicaid Beneficiaries With Hepatitis C Received Treatment Within 6 Months: OIG

Thursday, November 5, 2026

Report Materials

More than 2 million Americans have hepatitis C. Thousands die from the disease each year despite the availability of oral medications that can cure hepatitis C with a simple, short course of treatment.
Hepatitis C treatment is crucial to reducing morbidity and mortality and to achieving HHS’s goal of eliminating hepatitis C as a public health threat in the United States by 2030.
Timely treatment can also generate significant savings for Federal health care programs by preventing costly complications from untreated infection.
Medicaid is one of the largest insurers of people with hepatitis C, underscoring the program’s key role in ensuring access to treatment. Dual-eligible beneficiaries (i.e., those enrolled in both Medicaid and Medicare) would primarily receive treatment for hepatitis C through Medicare rather than Medicaid.

Only 23 percent of Medicaid beneficiaries with hepatitis C received treatment within 6 months of testing.
For those treated within 6 months, treatment typically took 7 weeks to start—despite recommendations to treat immediately.
Among individual States, the rate of beneficiaries treated within 6 months ranged from 7 percent to 41 percent.
Treatment rates were lower among certain populations, including newly infected beneficiaries, dual-eligible beneficiaries, older adults, and children.

OIG recommends that CMS:

Take additional steps to increase hepatitis C treatment rates in Medicaid, building on data collected through the Medicaid hepatitis C quality measure starting in 2027.
Take targeted steps to increase hepatitis C treatment rates among dual-eligible beneficiaries who receive treatment primarily through Medicare.

CMS concurred with our recommendations.