MedicaidPrior AuthMedium impact
BT2022118: Pharmacy updates approved by Drug Utilization Review Board December 2022
Indiana Medicaid (IHCP)·IN · Endocrinology, Family Medicine, Internal Medicine·Prior Authorization
Effective date
Feb 1, 2023
We identified it
Jun 19, 2026
Summary
Indiana Medicaid updated prior authorization criteria for GLP-1 Receptor Agonists and established new PA requirements for Non-PDL Agents with Step Therapy. These changes affect the automated SilentAuth system and will require prior authorization for specific pharmacy benefits.
Action Required
By February 1, 2023: Billing and pharmacy staff must review updated prior authorization criteria for GLP-1 Receptor Agonists and new Non-PDL Agents PA requirements on the OptumRx Indiana Medicaid website. Update pharmacy billing workflows to ensure PA requests are submitted through the enhanced SilentAuth system. Contact OptumRx Clinical Help Desk at 855-577-6317 for PA questions.