MedicaidPrior AuthMedium impact
BT2025112: Pharmacy updates approved by Drug Utilization Review Board July 2025
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, Rheumatology +3 more·Prior Authorization
Effective date
Sep 1, 2025
We identified it
Jun 18, 2026
Summary
Indiana Medicaid has updated prior authorization criteria for multiple drug classes including opioids, targeted immunomodulators, and GLP-1 medications, with changes to preferred drug lists effective September 1 and October 1, 2025. Several medications including Cosentyx and Siliq are being moved from preferred to nonpreferred status, requiring additional authorization steps.
Action Required
By September 1, 2025: Update prior authorization protocols for Targeted Immunomodulators - Cosentyx and Siliq now require nonpreferred authorization instead of preferred status. By October 1, 2025: Implement new PA requirements for Opioid Overutilization, Pulmonary Antihypertensives, GLP-1/GIP medications, and update Pradaxa to nonpreferred status while dabigatran capsule becomes preferred. Review current patient prescriptions for affected medications and obtain new prior authorizations where required to prevent claim denials.