Indiana Medicaid: New prior authorization requirements for additional incontinence products
AI Summary
Starting January 1, 2026, UnitedHealthcare will require prior authorization for most incontinence products when the service exceeds the monthly monetary benefit limit for Indiana Medicaid members. This applies to UnitedHealthcare Community Plan of Indiana, Indiana PathWays for Aging, and Hoosier Care Connect plans.
Action Required
By January 1, 2026: Billing team must update prior authorization workflows for incontinence products exceeding monthly benefit limits for Indiana Medicaid members. Ensure nursing assessments are performed by licensed nurses employed by the supplying provider. Submit prior authorization requests via fax to 844-897-6514 with universal provider authorization form and medical necessity documentation including nursing assessment, clinical documentation, and actual quantity needed per month. Claims without proper prior authorization will be denied.
Plan Types
Medicaid
States
IN
Specialties
urology, family-medicine, internal-medicine, geriatrics, ob-gyn