MedicaidPrior AuthHigh impact
BT202433: IHCP announces expansion of the SUPDL to include drugs reimbursed through medical benefits
Indiana Medicaid (IHCP)·IN·Provider Bulletin
Effective date
Apr 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) is expanding the Statewide Uniform Preferred Drug List (SUPDL) requirements to include physician-administered drugs reimbursed through medical benefits. Starting April 1, 2024, all physician-administered drugs on the SUPDL must follow the same step therapy, utilization edits, and prior authorization criteria as fee-for-service requirements, regardless of whether they're reimbursed through pharmacy or medical benefits.
Action Required
By April 1, 2024: Providers must follow SUPDL requirements for all physician-administered drugs reimbursed through medical benefits. Billing team must verify prior authorization requirements using the Optum Rx Indiana Medicaid website before administering covered drugs. Contact Acentra Health Customer Service at 866-725-9991 for FFS physician-administered drug PA questions or the respective MCE for managed care members. Failure to follow SUPDL requirements may result in claim denials.