MedicaidPrior AuthMedium impact
BT2023146: Pharmacy updates approved by Drug Utilization Review Board October 2023
Indiana Medicaid (IHCP)·IN · Neurology, Dermatology, Family Medicine +1 more·Prior Authorization
Effective date
Dec 1, 2023
We identified it
Jun 19, 2026
Summary
Indiana Medicaid has updated prior authorization criteria for Multiple Sclerosis Agents and established new PA requirements for Non-SUPDL medications and Skyclarys, while adding several over-the-counter drugs including naloxone nasal spray to their preferred formulary. These changes affect fee-for-service Indiana Medicaid patients and automated prior authorization processing.
Action Required
By December 1, 2023: Billing team must review updated prior authorization criteria for Multiple Sclerosis Agents on the Optum Rx Indiana Medicaid website and implement new PA requirements for Non-SUPDL medications and Skyclarys in billing system. Update encounter forms to reflect new OTC coverage for naloxone nasal spray, benzoyl peroxide, and antifungal medications for Indiana Medicaid fee-for-service patients. Contact Optum Rx Clinical Help Desk at 855-577-6317 for PA questions.