MedicaidPrior AuthMedium impact
BT202195: Pharmacy updates approved by Drug Utilization Review Board October 2021
Indiana Medicaid (IHCP)·IN · Pulmonology, Endocrinology, Gastroenterology +6 more·Prior Authorization
Effective date
Dec 1, 2021
We identified it
Jun 19, 2026
Summary
Indiana Medicaid has updated prior authorization criteria for multiple drug categories including Cystic Fibrosis Inhaled Agents, Pulmonary Antihypertensives, Sedative-Hypnotics/Benzodiazepines, and many others. The SilentAuth automated PA system has also been enhanced for several medication categories.
Action Required
Before December 1, 2021: Billing and clinical staff must review updated prior authorization criteria on the OptumRx Indiana Medicaid website for affected drug categories. Update prescription workflows to ensure compliance with new PA requirements for Cystic Fibrosis Inhaled Agents, Hematinic Agents, Pulmonary Antihypertensives, Sandostatin, Sedative-Hypnotics/Benzodiazepines, Soriatane, Topical Immunomodulators, Allergy-Specific Immunotherapy, Elmiron, Hepatitis B Agents, Muscular Dystrophy Agents, Mepron, Narcolepsy Agents, Oxervate, Sickle Cell Agents, Testosterones, Uterine Disorder Agents, and Vyndaqel/Vyndamax. Contact OptumRx Clinical Help Desk at 855-577-6317 for FFS PA questions.