Using the Hepatitis C Virus (HCV) as a focal point and newly approved Direct-Acting Antivirals as the impetus for change, this thesis explores the course of events when states fail to adhere to the federal mandates regarding Medicaid beneficiaries access to outpatient pharmaceuticals. The researcher analyzed how pressure against restrictive regulatory violations generates momentum to create and find alternative means of funding and procurement. Beginning with federal healthcare policy and moving to state implementation, the researcher used state Medicaid prior authorization restrictions on new, innovative cures for Hepatitis C as an example to argue that the Medicaid system, in its current form, is tolerating blatant non-compliance and failing to provide the federally mandated care for its beneficiaries suffering from Hepatitis C. The researcher concluded with a recommendation to model supplemental federal support in a manner similar to the Ryan White CARE Act.