Michigan's hepatitis C infections doubled last decade, but payment changes could cut numbers Ponni Perumalswami Michigan's removal of prior authorization last month for Medicaid patients to receive expensive but effective hepatitis C medications could begin to expand access to the cure for up to 200,000 people in the state living with the virus, said a University of Michigan specialty physician. If left untreated, hepatitis C can cause cause liver damage or cancer and death, said Dr. Ponni Perumalswami, a Michigan Medicine gastroenterologist and transplant hepatologist. Despite advances in treatment for hepatitis C the past four years, Michigan has seen a 71% increase in acute cases over the same time period.