MedicaidPrior AuthHigh impact
BT2025183: MDwise prior authorization and utilization management transition update provided
Indiana Medicaid (IHCP)·IN·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 18, 2026
Summary
MDwise is exiting the Indiana Medicaid managed care market effective January 1, 2026. Providers must transition prior authorization requests for dates of service on/after Jan 1, 2026 to members' new managed care entities, while MDwise will continue processing requests for services through Dec 31, 2025 until March 31, 2026.
Action Required
By January 1, 2026: Billing team must identify all MDwise HIP and Hoosier Healthwise members and determine their new managed care entities. Submit all prior authorization requests for dates of service on/after Jan 1, 2026 to the new MCEs, not MDwise. Continue submitting authorization requests for services through Dec 31, 2025 to MDwise until March 31, 2026. Update billing system to route authorizations correctly based on service dates. After April 1, 2026, stop using MDwise PA fax numbers and portal as they will be non-operational.