MedicaidPrior AuthMedium impact
BT202225: Pharmacy updates approved by Drug Utilization Review Board March 2022
Indiana Medicaid (IHCP)·IN·Prior Authorization
Effective date
May 1, 2022
We identified it
Jun 19, 2026
Summary
Indiana Medicaid updated prior authorization criteria for sedative hypnotics/benzodiazepines and several other drug categories, plus modified vaccine coverage rules including age restrictions and quantity limits for Hepatitis A, Hepatitis B, and meningococcal vaccines.
Action Required
By May 1, 2022: Billing team must review updated prior authorization requirements for sedative hypnotics/benzodiazepines, Carafate, Cytotec, muscular dystrophy agents, and sickle cell agents on the OptumRx Indiana Medicaid website. Update pharmacy billing systems to reflect new vaccine age restrictions (Hepatitis A/B now 19+ years only) and quantity limits (Hepatitis B: 1 dose/28 days, Meningococcal vaccines: 1 dose/56 days). Contact OptumRx at 855-577-6317 for prior authorization questions.