Indiana Code Title 27. Insurance § 27-1-37.5-16

Sec. 16. (a) Except as provided in subsection (b), the department shall establish, post, and maintain on the department's website a standardized prior authorization form for use by health care providers and utilization review entities for purposes of any notice or authorization required by a utilization review entity with respect to payment for a health care service rendered to a covered individual.

(b) After December 31, 2020, a Medicaid managed care organization (as defined in IC 12-7-2-126.9) shall use a standardized prior authorization form prescribed by the office of the secretary of family and social services.