MedicaidAdministrativeHigh impact
BT2025191: MDwise transition update for drug-related claims and PAs under the pharmacy and medical benefits
Indiana Medicaid (IHCP)·IN·Pharmacy
Effective date
Jan 1, 2026
We identified it
Jun 18, 2026
Summary
MDwise is no longer a managed care option for HIP and Hoosier Healthwise members effective January 1, 2026. This bulletin provides transition processes for pharmacy and medical drug claims, prior authorizations, and appeals with specific deadlines for submitting claims with 2025 dates of service.
Action Required
By January 1, 2026: Stop submitting new claims or prior authorization requests to MDwise for dates of service on or after January 1, 2026 - submit these to the member's new managed care entity instead. By March 31, 2026: Submit any remaining pharmacy claims with 2025 dates of service to MedImpact using BIN 017142, PCN ASPROD1, Group MDW. By January 10, 2026: Submit any pharmacy appeals for denied medication requests with 2025 dates of service to MDwise via fax 317-822-7582. By January 31, 2026: Submit any pharmacy prior authorization requests for 2025 dates of service to MedImpact via fax 858-790-7100. Update billing team procedures to identify MDwise members and redirect claims appropriately based on service dates.