MedicaidPrior AuthMedium impact
BT2020114: Pharmacy updates approved by Drug Utilization Review Board October 2020
Indiana Medicaid (IHCP)·IN · Hematology, Oncology, Internal Medicine +2 more·Prior Authorization
Effective date
Dec 1, 2020
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs established new prior authorization criteria for Sickle Cell Agents effective December 1, 2020. Healthcare providers must obtain prior authorization before prescribing these medications for Medicaid fee-for-service patients.
Action Required
Before December 1, 2020: Billing team and providers must implement prior authorization requirements for all Sickle Cell Agent prescriptions for Indiana Medicaid fee-for-service patients. Review PA criteria on OptumRx Indiana Medicaid website accessible via in.gov/medicaid/providers. Contact OptumRx Clinical Help Desk at 1-855-577-6317 for PA requests and questions. Prescriptions without prior authorization will be denied.