MedicaidPrior AuthMedium impact
BT202423: Pharmacy updates approved by Drug Utilization Review Board February 2024
Indiana Medicaid (IHCP)·IN·Prior Authorization
Effective date
Apr 1, 2024
We identified it
Jun 19, 2026
Summary
Indiana Medicaid updated prior authorization requirements and drug coverage for multiple medication categories including respiratory biologics, mental health medications, and various drug classes. Key changes include new PA criteria for Hepatitis C agents, utilization edits for Zurzuvae (mental health medication), and extensive updates to the Statewide Uniform Preferred Drug List affecting step therapy requirements.
Action Required
By April 1, 2024: Billing and clinical teams must update prior authorization workflows for Multiple Sclerosis Agents, Respiratory and Allergy Biologics, and Targeted Immunomodulators. Download updated PA criteria from Optum Rx Indiana Medicaid website. Update formulary information for all SUPDL changes including new step therapy requirements for respiratory medications, cardiac medications, and contraceptives. Verify patient eligibility and obtain required prior authorizations before prescribing affected medications to avoid claim denials.