MedicaidAdministrativeMedium impact
BT202483: IHCP reminds providers about the FFS prior authorization appeal process
Indiana Medicaid (IHCP)·IN·Prior Authorization
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) reminds providers that they must first complete the administrative review process through the fee-for-service prior authorization contractor before filing a state fair hearing appeal with OALP. If still dissatisfied after administrative review, providers can appeal to the Office of Administrative Law Proceedings with required documentation.
Action Required
Immediately: Billing and prior authorization staff must update appeal procedures to ensure administrative review through FFS PA contractor is completed BEFORE filing state fair hearing appeals. Train staff on two-step appeal process: 1) Administrative review with PA contractor first, 2) State fair hearing with OALP second. Update appeal tracking workflows to include both steps and required OALP contact information (fax: 317-232-4412, email: fssa.appeals@oalp.in.gov). Ensure PA notification letters are included with all OALP appeals.