MedicaidPrior AuthMedium impact
BT2024214: Pharmacy updates approved by Drug Utilization Review Board December 2024
Indiana Medicaid (IHCP)·IN · Ophthalmology, Neurology·Prior Authorization
Effective date
Feb 1, 2025
We identified it
Jun 19, 2026
Summary
Indiana Medicaid updated pharmacy prior authorization requirements and drug formularies effective February 2025. New PA criteria established for Daybue and Non-SUPDL agents, and timolol hemihydrate 0.5% eye drops moved from preferred to non-preferred status while Betimol 0.5% added to preferred brand list.
Action Required
By February 1, 2025: Billing team must update prior authorization protocols for Daybue and Non-SUPDL pharmacy agents for Indiana Medicaid fee-for-service patients. Update billing system to reflect timolol hemihydrate 0.5% as non-preferred and Betimol 0.5% as preferred brand. Review PA criteria on Optum Rx Indiana Medicaid website. For managed care patients, implement changes by February 15, 2025.