MedicaidPrior AuthMedium impact
BT202473: Pharmacy updates approved by Drug Utilization Review Board May 2024
Indiana Medicaid (IHCP)·IN · Endocrinology, Psychiatry, Gastroenterology +4 more·Prior Authorization
Effective date
Jul 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid has updated prior authorization criteria for multiple drug classes and made changes to the Statewide Uniform Preferred Drug List (SUPDL), affecting which medications require PA and their preferred status. Mental health medication utilization edits have also been revised with new quantity limits.
Action Required
By July 1, 2024: Billing team must review updated prior authorization criteria on the Optum Rx Indiana Medicaid website for affected drug classes including Dry Eye Disease agents, GLP-1 RA agents, Growth Hormones, Opioid treatments, and others. Update internal medication lists to reflect new preferred/non-preferred status changes. Verify PA requirements before prescribing affected medications to Indiana Medicaid patients to prevent claim denials.