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Legislative Update: SEA 480 Implementation

Date: 10/08/25

In accordance with Indiana Senate Enrolled Act 480 (SEA 480), MHS will implement new Prior Authorization (PA) processing standards effective July 1, 2025. These changes are designed to streamline care by ensuring quicker decision making and response times for providers and members.

What’s Changing?

Beginning July 1, 2025, the following PA timelines will apply:

Urgent (Expedited) Requests

  • Review within 24 hours of receiving a complete request.

Non-Urgent Requests

  • Review and determination issued within 48 hours of receiving a complete request.

Adverse Determination Response Window for Providers

  • Providers must respond within 48 hours after the decision is rendered to:
    1. Correct the request.
    2. Update information.
    3. Appeal the decision.

Peer-to-Peer Reviews

  • MHS will make all efforts to conduct peer-to-peer reviews within 48 hours of provider requests.

Appeal Acknowledgements

  • MHS will respond within 48 hours of receipt.

Timelines exclude weekends and all state or federally recognized holidays.

What Actions Providers May Need to Take:

  • Review your internal PA submission workflows to ensure alignment with the new timelines.
  • Educate your administrative and clinical teams about the new expectations and required response times.
  • Contact your Provider Engagement Account Manager (PEAM) with any questions or concerns. Find the  Provider Contact Map.

As always, thank you for being our partner in care. If you have any additional questions or need assistance, please contact the MHS Contact Center at 1-877-647-4848 (TTY: 1-800-743-3333), available Monday through Friday, from 8 a.m. to 8 p.m. EST.



Last Updated: 10/08/2025