Have you Heard

…that the Indiana Health Coverage programs (IHCP) will require Prior Authorization for “Brand Medically Necessary” mental health drugs as of July 1, 2011? According to the IHCP Bulletin (BT201111, MAY 17, 2011) “effective for pharmacy claims with dates of service on or after July 1, 2011, all claims for Indiana Medicaid-covered mental health drugs will require PA for “brand medically necessary.” This requirement pertains to all prescriptions written on or after July 1, 2011, and to refills of prescriptions written prior to July 1, 2011.” This change is a result of 2010/2011 Indiana General Assembly which removed the previous exemption from September 2001. The IHCP Bulletin stated that “since September 2001, a prescriber’s specification of “brand medically necessary” has required prior authorization (PA) in order for Indiana Medicaid to reimburse for a prescribed brand-name product when a less expensive generic equivalent is available. Mental health drugs, however, were exempt from this requirement.” For more detailed information regarding this significant change, including how to request Prior Authorizations, please go to: http://provider.indianamedicaid.com/ihcp/Bulletins/BT201111.pdf