MedicaidPrior AuthMedium impact
BT202271: Pharmacy updates approved by Drug Utilization Review Board August 2022
Indiana Medicaid (IHCP)·IN · Psychiatry, Pulmonology, Cardiology +5 more·Prior Authorization
Effective date
Oct 1, 2022
We identified it
Jun 19, 2026
Summary
Indiana Medicaid updated prior authorization criteria for multiple drug classes and made changes to the Preferred Drug List, including enhanced automated PA system criteria and new mental health medication utilization edits. These changes affect pharmacy benefits for fee-for-service Medicaid members only.
Action Required
Before October 1, 2022: Billing team must review updated prior authorization criteria for affected drug classes on the OptumRx Indiana Medicaid website. Update pharmacy benefit verification processes to reflect new PDL status changes and utilization edits for mental health medications. Contact OptumRx Clinical Help Desk at 855-577-6317 for PA requests and questions about fee-for-service PDL changes.