Pharmacy Policies

Effective July 5, 2023, CareSource will be aligning with Indiana Medicaid’s Statewide Uniform Preferred Drug List (SUPDL). We will maintain the same preferred and non-preferred drug status, clinical criteria requirements, and format for prior authorization (PA) submissions for products on the SUPDL.

The SUPDL and related criteria can be found on the Indiana Health Coverage Programs (IHCP) Pharmacy Services page. Select Preferred Drug List from the Preferred Products dropdown menu to launch the SUPDL. Prior Authorization (PA) criteria links can be found with the associated Drug Class within this document. Note: CareSource PA Forms are available on the Forms page under Pharmacy Prior Authorizations.

CareSource will continue to maintain and post a Preferred Drug List (PDL), which will include SUPDL preferred products and preferred products in categories outside of the SUPDL. CareSource updates the PDL regularly. Visit the Drug Formulary page for more information.

These pharmacy policies apply to preferred products in categories outside of the SUPDL for our Indiana Medicaid plan(s).

Pharmacy policies offer guidance on determination of medical necessity coverage of pharmaceutical products. The coverage criteria are consistent with FDA-approved prescribing information, treatment guidelines and literature. The policies listed on this page are not inclusive of all pharmaceutical products. New policies will be added as new pharmaceutical products become available or as needed. Existing policies are regularly reviewed and updated to reflect current treatment guidelines and prescribing information.