MedicaidAdministrativeMedium impact
BT202439: IHCP provides instruction for enteral and parenteral nutrition DME information form
Indiana Medicaid (IHCP)·IN · Gastroenterology, General Surgery, Critical Care +2 more·Provider Bulletin
Effective date
Apr 2, 2024
We identified it
Jun 19, 2026
Summary
IHCP clarified that the DME Information Form for enteral and parenteral nutrition products must be signed by the supplier, not the physician, and must be submitted with prior authorization requests along with a physician's signed order. The form must also be kept on file for ALL enteral and parenteral nutrition products, even those not requiring prior authorization.
Action Required
Immediately: Update prior authorization workflow for enteral and parenteral nutrition products to ensure DME Information Form is signed by supplier (not physician) and submitted with physician's signed order. Create filing system to maintain DME forms on file for ALL enteral/parenteral nutrition products, including those not requiring PA. Train staff that TPN products for hyperalimentation and PEN pumps are PA-exempt but still require forms on file.