MedicaidPrior AuthMedium impact
BT202337: Pharmacy updates approved by Drug Utilization Review Board April 2023
Indiana Medicaid (IHCP)·IN · Pulmonology, Allergy & Immunology, Internal Medicine +1 more·Prior Authorization
Effective date
Jun 1, 2023
We identified it
Jun 19, 2026
Summary
Indiana Medicaid has updated prior authorization criteria for Respiratory and Allergy Biologics through their SilentAuth automated system, effective June 1, 2023. This affects fee-for-service pharmacy benefits only and requires updated PA requests for these specific biologic medications.
Action Required
By June 1, 2023: Billing and pharmacy teams must review updated prior authorization criteria for Respiratory and Allergy Biologics on the Optum Rx Indiana Medicaid website before submitting PA requests. For FFS PA requests and questions, contact Optum Rx Clinical and Technical Help Desk at 855-577-6317. Failure to follow new criteria may result in PA denials.