MedicaidPrior AuthMedium impact
BT202001: Pharmacy update approved by Drug Utilization Review Board December 2019
Indiana Medicaid (IHCP)·IN · Neurology, PM&R (Physical Medicine & Rehab), Pediatrics +2 more·Prior Authorization
Effective date
Feb 1, 2020
We identified it
Jun 19, 2026
Summary
Indiana Medicaid has established new prior authorization requirements for Muscular Dystrophy Agents, effective February 1, 2020. Providers must obtain prior authorization through OptumRx for these medications before prescribing to Indiana Medicaid fee-for-service patients.
Action Required
Before February 1, 2020: Providers treating muscular dystrophy patients with Indiana Medicaid fee-for-service coverage must obtain prior authorization for Muscular Dystrophy Agents through OptumRx (1-855-577-6317). Review PA criteria and forms on the OptumRx Indiana Medicaid website. Update EMR templates to flag these medications for prior auth. Claims submitted without prior authorization will be denied.