MedicaidPrior AuthMedium impact
BT202207: Pharmacy updates approved by Drug Utilization Review Board January 2022
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Prior Authorization
Effective date
Mar 3, 2022
We identified it
Jun 19, 2026
Summary
Indiana Medicaid updated its automated prior authorization system for Targeted Immunomodulators, established new PA criteria for Sickle Cell Agents and Non-PDL Agents, and modified the Preferred Drug List with a quantity limit change for azithromycin 500mg tablets (limited to 7 tablets per 30 days).
Action Required
Before March 3, 2022: Billing team must update prior authorization procedures for Targeted Immunomodulators, Sickle Cell Agents, and Non-PDL Agents by reviewing new PA criteria on OptumRx Indiana Medicaid website. Pharmacy staff must limit azithromycin 500mg tablet dispensing to maximum 7 tablets per 30 days for Indiana Medicaid FFS patients. Contact OptumRx Clinical Help Desk at 855-577-6317 for PA questions.