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State of Maine Department of Health & Human Services Maintain/MODEL Prior Authorization Form HEPATITIS C TREATMENT Phone: 18884450497www.mainecarepdl.organ: 18888796938MaineCare will approve hepatitis
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What is HEPATITIS C TREATMENT Form?

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Hepatitis C treatment involves antiviral medications that can cure the infection.
Medical professionals are required to file information on hepatitis C treatment for their patients.
Hepatitis C treatment should be filled out with information on the prescribed medications, dosages, and treatment duration.
The purpose of hepatitis C treatment is to cure the infection and reduce the risk of complications such as liver damage.
Information on the prescribed antiviral medications, dosages, and treatment duration must be reported.
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