MedicaidDocumentationMedium impact
[Indiana] Pharmacy Policy Network Notification
CareSource·IN · Pharmacy·Pharmacy
Effective date
Mar 16, 2026
We identified it
May 9, 2026
Summary
CareSource Indiana Medicaid is implementing a new pharmacy policy titled 'Medical Necessity for DAW' (Dispense as Written) effective March 16, 2026. This is a NEW policy that will establish medical necessity requirements for DAW requests on prescription medications for Indiana Medicaid members. Billing teams must review the full policy details and update pharmacy claim submission procedures to comply with the new medical necessity documentation requirements.
Action Required
By March 16, 2026: Pharmacy and billing teams must review the complete 'Medical Necessity for DAW' policy (IN-MED-P-5002000) by visiting CareSource.com > Providers > Tools & Resources > Provider Policies > Indiana Medicaid > Pharmacy section. Update pharmacy claim submission workflows and provider education materials to reflect new medical necessity documentation requirements for DAW requests. Train staff on what documentation must be collected from prescribers before submitting DAW claims to CareSource Indiana Medicaid. Update any claim submission templates or systems to enforce new medical necessity requirements. Failure to comply may result in DAW claim denials.