MedicaidPrior AuthMedium impact
BT202618: Pharmacy updates approved by Drug Utilization Review Board January 2026
Indiana Medicaid (IHCP)·IN · Neurology, Pulmonology, Allergy & Immunology +4 more·Prior Authorization
Effective date
Apr 1, 2026
We identified it
Jun 18, 2026
Summary
Indiana Medicaid updated prior authorization requirements and preferred drug lists for multiple medication categories including respiratory drugs, multiple sclerosis medications, and antihistamines. Many drugs were removed from preferred status or require new step therapy protocols.
Action Required
By April 1, 2026: Billing team must update prior authorization protocols for multiple drug categories including antimigraine, respiratory biologics, multiple sclerosis, and targeted immunomodulators. Review updated PA criteria on Optum Rx Indiana Medicaid website. Update encounter forms to alert providers about new step therapy requirements for medications like Breztri Aerosphere, Trelegy Ellipta, and desloratadine. Contact Optum Rx Clinical Help Desk at 855-577-6317 for questions about fee-for-service PA requirements.