MedicaidPrior AuthMedium impact
BT202351: Pharmacy updates approved by Drug Utilization Review Board May 2023
Indiana Medicaid (IHCP)·IN · Psychiatry, Endocrinology, Gastroenterology +3 more·Prior Authorization
Effective date
Jul 1, 2023
We identified it
Jun 19, 2026
Summary
Indiana Medicaid updated its Preferred Drug List (PDL) and prior authorization requirements for numerous medication classes, effective July 1, 2023. Changes include new PA criteria for medications like Aduhelm and Growth Hormone, updated utilization limits for mental health medications, and status changes for drugs across multiple therapeutic categories.
Action Required
By July 1, 2023: Billing team must update prior authorization workflows for affected medication classes including Antipsychotic Agents, GLP-1 Receptor Agonists, Proton Pump Inhibitors, and others. Review updated PA criteria on Optum Rx Indiana Medicaid website. Update pharmacy billing systems to reflect new PDL status changes and quantity limits for mental health medications. Verify PA requirements before dispensing newly affected medications to avoid claim denials.