MedicaidPrior AuthMedium impact
BT202684: Pharmacy updates approved by Drug Utilization Review Board May 2026
Indiana Medicaid (IHCP)·IN · Cardiology, Pulmonology, Endocrinology +2 more·Prior Authorization
Effective date
Aug 1, 2026
We identified it
Jun 18, 2026
Summary
Indiana Medicaid updated prior authorization criteria for several drug classes and changed preferred/non-preferred status for specific medications including antimigraine, cardiac, and pulmonary drugs. The changes affect both fee-for-service and managed care Medicaid claims.
Action Required
By August 1, 2026: Billing team must update prior authorization workflows for Pulmonary Antihypertensives, Agents for Metabolic Disorders, Agents for Treatment of Cystic Fibrosis, Egrifta, and Non-SUPDL agents in billing system. Update drug formulary references to reflect new preferred/non-preferred status changes for ticagrelor, bosentan, azilsartan, and topiramate. Contact Optum Rx at 855-577-6317 for FFS questions or relevant MCO for managed care prior authorization requirements.