July 23, 2025
As part of our Clinical Practice Guidelines, we adopted the guideline for testing, managing and treating of hepatitis C virus infection from the American Association for the Study of Liver Diseases and Infectious Diseases Society of America. This guideline is now a part of our quality strategy to close care gaps and improve HCV-related outcomes for high-risk populations.
Why this matters: Hepatitis C is a serious public health issue that disproportionately affects individuals with limited access to care. As part of our commitment to improving equity and outcomes, we encourage providers to align with national best practices to support early detection, timely treatment and successful cure of hepatitis C across all populations.
Key updates in the guideline include:
- Recommended one-time HCV screening for anyone 18 years or older and a screening for pregnant members during each pregnancy
- Simplified treatment algorithms for adults without cirrhosis or with compensated cirrhosis
- No genotype testing or intensive monitoring is required for eligible individuals
- Expanded eligibility for HIV-HCV co-infected members
- New treatment guidance to support clinicians when HCV patients miss doses
- Children ages 3 years and older are now eligible for direct-acting antiviral therapy
- Guidance on key populations to address care for people who inject drugs, incarcerated individuals, solid organ transplant recipients and pregnant members, among other unique populations
This guideline supports our quality goals to:
- Increase rates of HCV identification and access to care
- Support providers in treatment of our members
- Contribute to the national goal of hepatitis C elimination by 2030
How you can help
Consider the following:
- Screening all eligible patients in accordance with the universal testing recommendation
- Initiating simplified treatment where appropriate or referring members to specialists if exclusions apply
Learn more about the guideline for HCV.
The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment. References to other third party sources or organizations are not a representation, warranty or endorsement of such organization. Any questions regarding those organizations should be addressed to them directly. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.