Prior Authorization in Indiana
Indiana enacted SB 3 (2020) requiring step therapy override protections. The law allows exceptions when the required step is contraindicated, was previously failed, or is expected to be ineffective. Indiana also requires PA decisions within specified timeframes and provides external review rights.
Key Facts About PA in Indiana
- ✓ Step therapy override law with standard exception criteria
- ✓ PA decisions must be timely with expedited review for urgent situations
- ✓ External review is available through the Indiana Department of Insurance
- ✓ Anthem BCBS is the dominant commercial carrier in Indiana
Quick Stats
- Typical Appeal Filing Window: 30 days
- External Review Available: Yes
- Major Payers: 4
Top Payers in Indiana
RxCheckUp generates payer-specific Letters of Medical Necessity for each of these Indiana carriers:
Anthem BCBS IndianaUnitedHealthcareCignaMDwise