MedicaidPrior AuthMedium impact
BT202115: Pharmacy updates approved by Drug Utilization Review Board February 2021
Indiana Medicaid (IHCP)·IN · Psychiatry, Pulmonology, Endocrinology +5 more·Prior Authorization
Effective date
Apr 1, 2021
We identified it
Jun 19, 2026
Summary
Indiana Medicaid updated pharmacy prior authorization criteria, preferred drug list status, and utilization limits for multiple drug categories including mental health medications, inhalers, blood pressure medications, and specialty drugs. These changes affect pharmacy benefits for fee-for-service Indiana Medicaid patients.
Action Required
By April 1, 2021: Review patient medication lists for Indiana Medicaid fee-for-service patients to identify affected drugs. Update prior authorization workflows for new PA requirements on Cushing's Disease Agents, Hetlioz, Cystic Fibrosis Agents, and Hepatitis C Agents. Verify current authorizations for drugs with updated criteria including SSRI/SNRI combinations, pulmonary antihypertensives, multiple sclerosis agents, and monoclonal antibodies for respiratory conditions. Access updated PA criteria at OptumRx Indiana Medicaid website via in.gov/medicaid/providers.