MedicaidPrior AuthMedium impact
BT202151: Pharmacy updates approved by Drug Utilization Review Board June 2021
Indiana Medicaid (IHCP)·IN · Gastroenterology, Infectious Disease, Neurology +3 more·Prior Authorization
Effective date
Aug 1, 2021
We identified it
Jun 19, 2026
Summary
Indiana Medicaid updated prior authorization criteria for multiple drug categories including Hepatitis C Agents, Multiple Sclerosis Agents, Proton Pump Inhibitors, and others. The SilentAuth automated system was enhanced and new PA requirements take effect August 1, 2021.
Action Required
By August 1, 2021: Billing and pharmacy staff must review updated prior authorization criteria on the OptumRx Indiana Medicaid website for Hepatitis C Agents, Targeted Immunomodulators, Multiple Sclerosis Agents, Proton Pump Inhibitors, COX2 and Select NSAIDs, Bone Formation agents, Cystic Fibrosis treatments, Lucemyra, Cipro Suspension, and Levaquin Solution. Update internal PA request processes to align with new SilentAuth criteria. Contact OptumRx Clinical Help Desk at 855-577-6317 for questions about fee-for-service PA requests.