MedicaidPrior AuthMedium impact
BT202306: Pharmacy updates approved by Drug Utilization Review Board January 2023
Indiana Medicaid (IHCP)·IN · Endocrinology, Family Medicine, Internal Medicine·Prior Authorization
Effective date
Mar 1, 2023
We identified it
Jun 19, 2026
Summary
Indiana Medicaid has updated prior authorization criteria for GLP-1 Receptor Agonists and established new PA requirements for Tzield (teplizumab), both effective March 1, 2023. These changes affect the automated SilentAuth PA system for fee-for-service pharmacy benefits.
Action Required
Before March 1, 2023: Billing and pharmacy staff must review updated prior authorization criteria for GLP-1 Receptor Agonists on the OptumRx Indiana Medicaid website and implement new PA requirements for Tzield (teplizumab). Update workflow to ensure PA requests are submitted using new criteria. Contact OptumRx Clinical Help Desk at 855-577-6317 for FFS PA questions.