MedicaidPrior AuthMedium impact
BT202594: Pharmacy updates approved by Drug Utilization Review Board June 2025
Indiana Medicaid (IHCP)·IN · Endocrinology, Nephrology, Pulmonology +3 more·Prior Authorization
Effective date
Aug 1, 2025
We identified it
Jun 18, 2026
Summary
Indiana Medicaid has updated prior authorization criteria for several drug classes and modified the Statewide Uniform Preferred Drug List, with changes affecting both fee-for-service and managed care claims. New PA requirements established for Cushing's Syndrome, Immunoglobulin A Nephropathy, and Transthyretin Impacting Agents, while several respiratory and diabetes medications changed preferred status.
Action Required
By August 1, 2025: Update prior authorization workflows for Cushing's Syndrome Agents, Immunoglobulin A Nephropathy Agents, Non-SUPDL Agents PA and Step Therapy, and Transthyretin Impacting Agents for fee-for-service Indiana Medicaid patients. Review current prescriptions for affected medications on the SUPDL changes (including umeclidinium/vilanterol, Airduo Respiclick, and sitagliptin products) to ensure proper authorization before claims submission. Download updated PA criteria from Optum Rx Indiana Medicaid website and train staff on new requirements.