MedicaidPrior AuthMedium impact
BT202544: Pharmacy updates approved by the Office of Medicaid Policy and Planning March 2025
Indiana Medicaid (IHCP)·IN · Gastroenterology, Cardiology, Ophthalmology·Pharmacy
Effective date
May 1, 2025
We identified it
Jun 19, 2026
Summary
Indiana Medicaid updated prior authorization requirements for MASH/MASLD agents and Non-SUPDL agents, changed rivaroxaban to nonpreferred status on the drug list, and updated the Preferred Brand Drug List by adding Xarelto 2.5mg and removing Bromsite eye drops.
Action Required
By May 1, 2025: Billing team must update pharmacy billing protocols to obtain prior authorization for MASH/MASLD agents and Non-SUPDL agents for fee-for-service Indiana Medicaid patients. Update system to reflect rivaroxaban as nonpreferred (requiring prior auth) and Xarelto 2.5mg as preferred brand. For managed care patients, implement changes by May 15, 2025. Access updated PA criteria on Optum Rx Indiana Medicaid website.