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Revised Indiana Diabetes Supply List

The Indiana Health Coverage Programs (IHCP) has revised the Preferred Diabetes Supply List (PDSL) that was previously announced to take effect on January 1, 2023. The revision was necessary due to some product discontinuations that would have impacted the original PDSL. The revised PDSL maintains preferred products from Dexcom, Roche, and Trividia, and allows members additional time to transition to preferred test strips by not requiring prior authorization for some nonpreferred strips through March 31, 2023. Providers should refer to the revised PDSL on the OptumRx Indiana Medicaid website and follow the claims submission guidance in the provider reference modules.
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0% found this document useful (0 votes)
28 views2 pages

Revised Indiana Diabetes Supply List

The Indiana Health Coverage Programs (IHCP) has revised the Preferred Diabetes Supply List (PDSL) that was previously announced to take effect on January 1, 2023. The revision was necessary due to some product discontinuations that would have impacted the original PDSL. The revised PDSL maintains preferred products from Dexcom, Roche, and Trividia, and allows members additional time to transition to preferred test strips by not requiring prior authorization for some nonpreferred strips through March 31, 2023. Providers should refer to the revised PDSL on the OptumRx Indiana Medicaid website and follow the claims submission guidance in the provider reference modules.
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© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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IHCP bulletin

INDIANA HEALTH COVERAGE PROGRAMS BT2022119 DECEMBER 29, 2022

IHCP revises recently announced Preferred


Diabetes Supply List updates
The Indiana Health Coverage Programs (IHCP) recently announced updates to the
Preferred Diabetes Supply List (PDSL), effective for dates of service (DOS) on or after
Jan. 1, 2023 (see IHCP Bulletin BT2022113).

The Indiana Family and Social Services Administration (FSSA) was subsequently notified
of product discontinuations that would impact the PDSL. As a result, the IHCP has
revised the PDSL to be implemented on Jan. 1, 2023 (see Table 1).

Table 1 – Revised Preferred Diabetes Supplies List, effective for claims with DOS on or after Jan. 1, 2023

Dexcom Products
Receiver Corresponding Sensor/Transmitter
Dexcom G6 Sensors
Dexcom G6 Receiver
Dexcom G6 Transmitter
Roche Products
Meters Corresponding Strips
Accu-Chek Guide Care Kit
Accu-Chek Guide Test Strips
Accu-Chek Guide Me Care Kit
Trividia Products
Meters Corresponding Strips
TRUE METRIX Meter
TRUE METRIX Test Strips
TRUE METRIX Air Meter
ReliOn Rx TMX Blood Glucose System ReliOn/TRUE METRIX Test Strips

To allow members time to transition to preferred diabetes supplies products, the IHCP will not require prior
authorization on the following nonpreferred blood glucose test strips until April 1, 2023:

◼ FreeStyle strips
◼ FreeStyle Insulinx strips
◼ FreeStyle Lite strips

For more information


The PDSL can be found on the OptumRx Indiana Medicaid website, accessible from the Pharmacy Services page at
[Link]/medicaid/provider. Pharmacy providers should refer to the Pharmacy Services provider reference module for
current guidance regarding fee-for-service (FFS) claims for PDSL products. Durable medical equipment (DME)
providers must continue to use the claim submission processes outlined in the Durable and Home Medical Equipment
and Supplies provider reference module.

Page 1 of 2
IHCP bulletin BT2022119 DECEMBER 29, 2022

Please direct PDSL-related questions about FFS members to the OptumRx Clinical and
Technical Help Desk by calling toll-free 855-577-6317. Questions regarding benefits and
claims for members in Healthy Indiana Plan (HIP), Hoosier Care Connect and Hoosier
Healthwise should be directed to the managed care entity (MCE) with which the member
is enrolled.

COPIES OF THIS PUBLICATION SIGN UP FOR IHCP EMAIL NOTIFICATIONS


If you need additional copies of this publication, To receive email notices of IHCP publications, subscribe
please download them from the IHCP Bulletins by clicking the blue subscription envelope
page of the IHCP provider website at or sign up from the IHCP provider website
[Link]/medicaid/providers. at [Link]/medicaid/providers.

Page 2 of 2

Common questions

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Questions related to the Preferred Diabetes Supply List for fee-for-service members should be directed to the OptumRx Clinical and Technical Help Desk using the toll-free number 855-577-6317 .

The updated Preferred Diabetes Supply List under Trividia includes the TRUE METRIX Meter, TRUE METRIX Test Strips, and the ReliOn Rx TMX Blood Glucose System, which uses the TRUE METRIX Test Strips for monitoring blood glucose levels .

The product discontinuations necessitated revisions to the Preferred Diabetes Supply List, leading to the introduction of new preferred diabetes products like the Dexcom G6 and Accu-Chek Guide systems. This change is crucial for maintaining supply availability and meeting patient needs .

Challenges such as member adaptation to new product lists and potential interruptions in diabetes care might arise. The IHCP addresses these issues by temporarily waiving prior authorization for certain nonpreferred strips until April 1, 2023, to facilitate a smooth transition .

Members have been given until April 1, 2023, to transition to the preferred diabetes supplies without requiring prior authorization for nonpreferred blood glucose test strips such as FreeStyle, FreeStyle Insulinx, and FreeStyle Lite strips. This accommodation ensures a smoother transition for members adjusting to the new Preferred Diabetes Supply List .

Pharmacy providers can access updated guidance regarding fee-for-service claims for the revised Preferred Diabetes Supplies List through the Pharmacy Services provider reference module on the Indiana Medicaid website. Durable medical equipment providers should use the claim submission processes outlined in the Durable and Home Medical Equipment provider reference module .

To receive updates on Indiana Health Coverage Programs publications, stakeholders can subscribe to email notices by clicking the subscription envelope or signing up on the IHCP provider website .

Providers needing additional copies of the IHCP bulletin can download them from the IHCP Bulletins page of the IHCP provider website .

The Indiana Health Coverage Programs revised the Preferred Diabetes Supply List effective January 1, 2023, due to product discontinuations. The list now includes Dexcom G6 Receivers, Sensors, and Transmitters, Accu-Chek Guide and Guide Me Care Kits with corresponding test strips, and Trividia TRUE METRIX Meters and Test Strips, including the ReliOn Rx TMX Blood Glucose System with TRUE METRIX Test Strips .

Members of managed care entities such as the Healthy Indiana Plan, Hoosier Care Connect, and Hoosier Healthwise should direct their benefits and claims inquiries to the managed care entity with which they are enrolled, ensuring issues are addressed within their specific plan’s framework .

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