MedicaidPrior AuthMedium impact
BT202409: Pharmacy updates approved by Drug Utilization Review Board January 2024
Indiana Medicaid (IHCP)·IN · Endocrinology, Pain Management, Family Medicine +2 more·Prior Authorization
Effective date
Mar 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid is updating prior authorization criteria for GLP-1 receptor agonists and opioid overutilization, establishing new PA requirements for several drug classes, and removing specific insulin products and OTC supplements from preferred formulary status.
Action Required
By March 1, 2024: Billing and pharmacy teams must update prior authorization workflows for GLP-1 receptor agonists and opioid prescriptions for Indiana Medicaid patients. Verify PA requirements on Optum Rx Indiana Medicaid website before submitting claims. Update systems to reflect that Levemir Flextouch/Vials and insulin degludec are now non-preferred and Enlyte Capsules, Inositol 650mg tablets, and L-methylfolate-algae capsules are no longer covered.