MedicaidPrior AuthHigh impact
BT2023130: IHCP updates transplant guidelines for colon cancer and urine drug screening
Indiana Medicaid (IHCP)·IN · Cardiothoracic Surgery, General Surgery, Nephrology +3 more·Pharmacy
Effective date
Nov 2, 2023
We identified it
Jun 19, 2026
Summary
Starting November 2, 2023, IHCP (Indiana Medicaid) requires additional screening documentation for all transplant prior authorizations: colon cancer screening for members over 45 and urine drug screens at physician discretion. This documentation must be maintained in medical records and submitted with PA requests.
Action Required
Before November 2, 2023: Update transplant prior authorization workflows to include colon cancer screening documentation for members over 45 and urine drug screen results when performed. Ensure medical records contain this documentation before submitting PA requests for lung, heart, kidney, liver, pancreatic, intestinal, multivesicular, and bone marrow/stem cell transplants. Review Laboratory Services module for urine drug screen PA requirements.