MedicaidPrior AuthMedium impact
BT2023168: Pharmacy updates approved by Drug Utilization Review Board November 2023
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, Pediatrics +4 more·Prior Authorization
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid has updated prior authorization criteria for multiple drug classes and made extensive changes to their Statewide Uniform Preferred Drug List (SUPDL), affecting pharmacy benefits for Medicaid patients. The changes include new PA requirements for opioid use disorder treatments, growth hormones, and other specialty medications, plus status changes for hundreds of drugs.
Action Required
By January 1, 2024: Pharmacy and billing staff must review updated prior authorization requirements for antipsychotic agents, antiseizure medications, GLP-1 receptor agonists, opioid treatments, and other affected drug classes. Update pharmacy systems with new preferred/non-preferred drug statuses and quantity limits. Verify PA criteria on Optum Rx Indiana Medicaid website before submitting requests. Claims for affected medications without proper authorization will be denied.