MedicaidPrior AuthMedium impact
BT202098: Pharmacy updates approved by Drug Utilization Review Board August 2020
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, Pediatrics +8 more·Prior Authorization
Effective date
Oct 1, 2020
We identified it
Jun 19, 2026
Summary
Indiana Medicaid updated prior authorization requirements, preferred drug list status, and utilization edits for multiple medication classes including antiseizure agents, diabetes medications, pain medications, and specialty drugs. These changes affect pharmacy benefit coverage and require new PA criteria for several drug categories.
Action Required
By October 1, 2020: Billing and clinical teams must review updated prior authorization criteria for affected medication classes on the OptumRx Indiana Medicaid website. Update internal formularies and clinical protocols to reflect new preferred/non-preferred drug status changes. Ensure providers are aware of new step therapy requirements for medications like Consensi, Trijardy XR, and laxatives/cathartics. Contact OptumRx Clinical Help Desk at 1-855-577-6317 for FFS PA requests.