The national treatment gap is 77 percentage points
HHS’s Office of Inspector General found that 23% of Medicaid beneficiaries with hepatitis C received treatment within six months of testing. Put another way, 77% did not receive treatment within that window—more than three times the treated share.
Among people who were treated within six months, the typical start was seven weeks after testing. OIG contrasted that delay with recommendations to treat immediately, because modern oral medicines can cure hepatitis C and prevent severe liver complications.
| Indicator | Finding |
|---|---|
| Treated within 6 months | 23% |
| Not treated within 6 months | 77% |
| Typical wait among those treated | 7 weeks |
| Lowest state rate | 7% |
| Highest state rate | 41% |
A sixfold state range points to policy and delivery differences
Individual state treatment rates ranged from 7% to 41%, a 34-point spread. The highest rate was 5.86 times the lowest. That range does not prove which single state policy caused better access, but it makes a uniform national explanation implausible.
Medicaid eligibility, screening follow-up, prior authorization, provider capacity, pharmacy access and coordination with Medicare can all affect treatment. OIG specifically identified lower rates among newly infected beneficiaries, dual-eligible beneficiaries, older adults and children.
CMS accepted two recommendations, but measurement starts later
OIG recommended that CMS take additional steps to increase Medicaid treatment rates, building on a hepatitis C quality measure beginning in 2027, and target dual-eligible beneficiaries whose drug coverage generally runs through Medicare. CMS concurred.
A new measure can expose gaps but does not itself fill them. Public accountability will require state-level follow-up showing whether the 2027 data produce faster initiation, narrower disparities and higher treatment rates rather than reporting alone.
Method, contribution and limits
What’s the Scoop With Broach converted OIG’s treated share into the complementary 77% gap and calculated the ratio between the highest and lowest state rates. The original contribution is presenting access, delay and interstate variation as separate accountability measures.
The OIG summary does not identify every reason an individual remained untreated, and dual-eligible patients may receive treatment through Medicare rather than Medicaid. This analysis does not treat a six-month claims gap as proof that every person received no clinical care.