OIG Report (OEI): Less Than 25 Percent of Medicaid Beneficiaries With Hepatitis C Received Treatment Within 6 Months

The OIG's Office of Evaluation and Inspections issued report OEI-BL-24-00450 on October 28, 2026, examining Medicaid beneficiaries diagnosed with hepatitis C and whether they received treatment within 6 months of testing. The report finds that only 23 percent of Medicaid beneficiaries with hepatitis C received treatment within that 6-month window. Among those who were treated within 6 months, the median time to treatment initiation was 7 weeks, despite clinical recommendations to treat immediately. State-level treatment rates varied substantially, ranging from a low of 7 percent to a high of 41 percent across individual states. Treatment rates were disproportionately lower among specific subpopulations, including newly infected beneficiaries, dual-eligible beneficiaries enrolled in both Medicaid and Medicare, older adults, and children. The report notes that dual-eligible beneficiaries receive hepatitis C treatment primarily through Medicare rather than Medicaid, creating a cross-program gap in access. The OIG frames timely hepatitis C treatment as both a clinical and fiscal priority, citing the availability of curative oral medications and noting that untreated infection generates costly downstream complications for federal health care programs. The report situates its findings within HHS's stated goal of eliminating hepatitis C as a public health threat in the United States by 2030. OIG issued two recommendations to CMS. First, CMS should take additional steps to increase hepatitis C treatment rates in Medicaid, building on data to be collected through the Medicaid hepatitis C quality measure beginning in 2027. Second, CMS should take targeted steps to increase treatment rates specifically among dual-eligible beneficiaries who receive treatment through Medicare. CMS concurred with both recommendations.