MedicaidPrior AuthMedium impact
BT2023136: IHCP announces updates to prior authorization and expands criteria for home oxygen policy
Indiana Medicaid (IHCP)·IN · Pulmonology, Internal Medicine, Family Medicine·Prior Authorization
Effective date
Nov 20, 2023
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) updated home oxygen policy effective November 20, 2023, creating distinction between termed and lifetime oxygen users, removing prior authorization requirements for certain changes for lifetime users, and expanding coverage criteria for nocturnal oxygen use.
Action Required
By November 20, 2023: Providers must use Certificate of Medical Necessity (CMN) for Oxygen form to designate patients as termed (less than 99) or lifetime (99) oxygen users. For lifetime users, mark '99' in Section B for Estimated Length of Need. Update PA submission processes - for Atrezzo Portal submissions, request 365-day authorizations for lifetime users and attach CMN; for phone/fax submissions to Kepro (866-725-9991), indicate 'lifetime user' and use '99' designation. Keep approved lifetime authorizations on file for member transitions between managed care entities.