MedicaidPrior AuthMedium impact
BT2024172: Pharmacy updates approved by Drug Utilization Review Board October 2024
Indiana Medicaid (IHCP)·IN · Psychiatry, Oncology, Pulmonology +1 more·Prior Authorization
Effective date
Dec 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid has updated prior authorization criteria for multiple drug categories including antipsychotics, immunotherapy agents, and specialty medications, plus revised the Preferred Drug List and mental health utilization edits. New PA requirements and drug list changes affect both fee-for-service and managed care Medicaid claims.
Action Required
By December 1, 2024: Review updated prior authorization criteria for Antipsychotic Agents, Intravesical Immunotherapy, Pulmonary Antihypertensives, Somatostatin Analogs, and other specialty medications on the Optum Rx Indiana Medicaid website. Update billing system to reflect new PA requirements and preferred drug list changes. For managed care claims, implement changes by December 15, 2024. Contact Optum Rx Clinical Help Desk at 855-577-6317 for FFS pharmacy PA questions.