MedicaidPrior AuthMedium impact
BT202282: Pharmacy updates approved by Drug Utilization Review Board September 2022
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, Neurology +2 more·Prior Authorization
Effective date
Nov 1, 2022
We identified it
Jun 19, 2026
Summary
Indiana Medicaid updated prior authorization criteria for Antimigraine Agents and established new PA requirements for Cystic Fibrosis Agents, while adding contraceptive drugs to the Preferred Drug List and creating an OTC Contraceptive Agents Formulary with quantity limits.
Action Required
By November 1, 2022: Billing team must update prior authorization workflows for Antimigraine Agents and Cystic Fibrosis Agents by reviewing updated PA criteria on OptumRx Indiana Medicaid website. Pharmacy staff should verify new quantity limits for Vascepa (4 grams/day, age 18+) and OTC contraceptives before dispensing. Contact OptumRx Clinical Help Desk at 855-577-6317 for PA requests.