Description
The Maryland Health Care Commission is seeking a contractor to conduct an analysis on the impact of limiting prior authorization for coverage of direct-acting antivirals for Hepatitis C. The contractor will provide actuarial services to assist the Commission in completing a legislative requirement to conduct a social, medical, and financial impact analysis. The scope of work includes evaluating the analysis, conducting carrier surveys, and providing a report with findings and recommendations. The contract term is from August 2026 to January 2027, with a fixed price of $65,000.
• The contractor will conduct a social evaluation, including the extent to which the coverage and reimbursement requirement is generally utilized by a significant portion of the population.
• The contractor will conduct a medical evaluation, including the extent to which the service is generally recognized by the medical community as being effective and efficacious in the treatment of patients.
• The contractor will conduct a financial evaluation, including an estimate of the marginal cost and full cost of requiring carriers to provide this coverage and reimbursement requirement.
• The contractor will conduct carrier surveys to gather information on insurance coverage policies specific to this analysis.
• The contractor will provide a report with findings and recommendations, including a Highlights page with bullet points on the medical, social, and financial impact.