MDwise
Prior Authorization

Prior Authorization

MDwise Medicaid Prior Authorization Process

For pharmacy prior authorization forms, please visit our pharmacy forms.

Resources

• Portal Instructions - New!
• Prior Authorization Reference Guide for Hoosier Healthwise and Healthy Indiana Plan
• Prior Authorization Appeal Request Form
• Universal Prior Authorization Form

Prior Authorization Lists

• The Medical Prior Authorization and Exclusion Lists for Hoosier Healthwise and HIP effective 1/1/23
• The Medical Prior Authorization and Exclusion Lists for Hoosier Healthwise and HIP effective 4/1/22
• 2023 Searchable Behavioral Health Services that Require Prior Authorization for Hoosier Healthwise and HIP effective 1/1/2023
• 2021 Searchable Behavioral Health Services that Require Prior Authorization for Hoosier Healthwise and HIP

For pharmacy prior authorization forms, please visit our pharmacy forms.