MedicaidPrior AuthMedium impact
BT202551: IHCP updates PA criteria for CAR-T therapies
Indiana Medicaid (IHCP)·IN · Oncology, Hematology·Provider Bulletin
Effective date
Jun 26, 2024
We identified it
Jun 18, 2026
Summary
IHCP (Indiana Medicaid) removed the REMS training requirement for healthcare providers administering CAR-T therapies and expanded coverage criteria for Tecartus to include relapsed or refractory acute lymphocytic leukemia. These changes are retroactive to June 26, 2024.
Action Required
Immediately: Billing team should review any denied CAR-T therapy claims from June 26, 2024 forward where REMS training documentation was the denial reason and resubmit with copy of this bulletin. For Tecartus (Q2053), update prior authorization criteria to include acute lymphocytic leukemia as covered diagnosis. Submit reconsideration requests for applicable denied PAs within 180 days of April 24, 2025.