MedicaidPrior AuthMedium impact
BT202625: Pharmacy updates approved by Drug Utilization Review Board February 2026
Indiana Medicaid (IHCP)·IN · Pulmonology, Nephrology, Endocrinology +4 more·Prior Authorization
Effective date
May 1, 2026
We identified it
Jun 18, 2026
Summary
The Indiana Medicaid program has updated prior authorization requirements for several drug categories and modified their preferred drug lists. New PA criteria will apply to Daybue, GLP-1/GIP agents, immunoglobulin nephropathy agents, and pulmonary phosphodiesterase inhibitors, with various drugs being moved between preferred and non-preferred status.
Action Required
Before May 1, 2026: Billing and clinical staff must update prior authorization procedures for Daybue, GLP-1/GIP combination agents, immunoglobulin A nephropathy agents, and pulmonary phosphodiesterase inhibitors for Indiana Medicaid FFS patients. Update drug formulary references to reflect new preferred/non-preferred status changes including Trelegy Ellipta step therapy requirements, erythromycin capsule removal, and methylphenidate patch preference changes. Review PA criteria on Optum Rx Indiana Medicaid website. Contact Optum Rx Clinical Help Desk at 855-577-6317 for FFS questions or respective MCE for managed care questions.