MedicaidPrior AuthMedium impact
BT2024101: Pharmacy updates approved by Drug Utilization Review Board June 2024
Indiana Medicaid (IHCP)·IN · Gastroenterology, Cardiology, Pulmonology +3 more·Prior Authorization
Effective date
Aug 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) has updated prior authorization criteria for Proton Pump Inhibitors and Pulmonary Antihypertensives, established new PA requirements for Hemophilia B Gene Therapy Agents, and modified the Statewide Uniform Preferred Drug List with changes to age limits and step therapy requirements for several drug classes.
Action Required
By August 1, 2024: Billing and pharmacy teams must review updated prior authorization criteria for Proton Pump Inhibitors and Pulmonary Antihypertensives on the Optum Rx Indiana Medicaid website. Establish workflows for new Hemophilia B Gene Therapy Agents PA requirements. Update step therapy protocols for valsartan solution, amlodipine solution, and baclofen formulations to reflect removal of age limits and new trial requirements. Contact Optum Rx Clinical Help Desk at 855-577-6317 for FFS PA questions.