MedicaidCoverageMedium impact
BT202078: Pharmacy updates approved by Drug Utilization Review Board June 2020
Indiana Medicaid (IHCP)·IN · Gastroenterology, Neurology, Endocrinology +2 more·Prior Authorization
Effective date
Aug 1, 2020
We identified it
Jun 19, 2026
Summary
Indiana Medicaid has removed Ranitidine from both the Over-the-Counter Drug Formulary and Preferred Drug List, and updated Ubrelvy quantity limits to 10 tablets per 30 days for antimigraine treatment. New prior authorization criteria were also established for GnRH Agents and Movement Disorder Agents.
Action Required
By August 1, 2020: Billing and pharmacy teams must stop prescribing/dispensing Ranitidine for Indiana Medicaid patients and switch to alternative H2 antagonists. Update pharmacy systems to reflect Ubrelvy quantity limit of 10 tablets per 30 days. Implement new prior authorization requirements for GnRH Agents and Movement Disorder Agents - obtain PA before prescribing these medications or claims will be denied.