Medicaid & Medicaid Waiver Updates
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Guide to Indiana’s Medicaid Waiver Program – Updated with 2024 changes to Indiana’s Medicaid Waivers.
July 1, 2024 Medicaid Waiver Changes
Amendments to Indiana’s Medicaid Waiver program went into effect on July 1, 2024 for the new PathWays for Aging and Health and Wellness (H&W) waivers – formerly combined in the Aged and Disabled (A&D) waiver. Amendments to the Community Integration and Habilitation (CIH), Family Supports (FSW), and Traumatic Brain Injury (TBI) waivers also went into effect.
Effective July 1, individuals age 59 and younger who had been receiving services through the Aged and Disabled waiver will receive services through the Health and Wellness waiver.
Indiana PathWays for Aging, a Medicaid managed care program for individuals aged 60 and over also launched on July 1. Some individuals on the PathWays program will qualify for additional services based on their needs and will be eligible for the PathWays Medicaid Waiver. Those individuals were also previously served by the Aged and Disabled Waiver.
Resources, including a guide for who to contact if you are in need of assistance, are available to help individuals navigate any challenges faced with the transition.
Information and resources for individuals transitioning from the Aged and Disabled Waiver to the Health and Wellness Waiver can be found on FSSA’s website.
For information about Indiana PathWays for Aging visit in.gov/PathWays.
Visit in.gov/fssa/medicaid-strategies for information and updates from FSSA
Fact Sheets on Medicaid Waiver Changes & Prior Authorization Medicaid State Plan Services
- PathWays for Aging Waiver
- Health & Wellness Waiver
- Traumatic Brain Injury Waiver
- Family Supports & CIH Waivers Prior Authorization Medicaid State Plan Services
Additional fact sheets
Why is This Happening
Families as Personal Care Attendants
Nursing Services
Structured Family Caregiving
Who Can be Paid for What Services Guide
FSSA Attendant Care and Structured Family Caregiving Relationship Guidance
A&D Waiver Attendant Care Service Activities Not Allowed
FSSA Guidance on Attendant Care, SFC, and LRIs
FSSA Attendant Care and Structured Family Caregiving Side by Side
FSSA March 15 Update for A&D Waiver Recipients and Families
Waiting Lists Update – October 11
FSSA announced Friday, October 11 that they are increasing the number of monthly invitations sent to individuals on the PathWays for Aging, Health and Wellness, and Family Supports Waiver waiting lists.
Individuals invited to proceed will receive a letter with further details.
Invitations to access the PathWays for Aging Waiver will increase from 800 to 1,200.
Invitations to access the Health and Wellness Waiver will increase from 125 to 500.
Invitations to access the Family Supports Waiver will increase from 175 to 200. These monthly invitations from the waiting list are in addition to the number of eligible individuals who meet priority criteria for accessing the FSW.
This expansion is not an increase in the number of available waiver slots. It is an increase in the number of individuals invited monthly to move forward with the process of accessing services.
The process to apply for, enroll, and receive services under a waiver is not changing. Individuals seeking to join the PathWays and Health and Wellness waiver waiting lists should continue to contact their local Area Agency on Aging to start the process.
Individuals wishing to access the Family Supports (FSW) Waiver can apply through The Bureau of Disabilities Services (BDS) gateway: bddsgateway.fssa.in.gov or contact their local Bureau of Disabilities Services office. You can check your status on the FSW waiver at in.gov/fssa/ddrs/information-for-individuals-and-families/bdds-waitlist-portal.
Resources including FAQs and process guides can be found on the FSSA Medicaid Strategies webpage.
Additional information about the waiting list can be found on the HCBS Waiver Waiting List Dashboard.
4.3.24 – Waiting list started for Health & Wellness Waiver
What happens when you are added to the waiting list
FSW & CIH Waiver Rewrite
The state is rewriting Indiana’s Family Supports Waiver and Community Integration & Habilitation Waiver. These waivers provide critical home and community based services. What changes would you like to see? What things are important to maintain? Click here for a link our to virutal town hall meeting recording.
DDRS Advisory Council Slides
DDRS Advisory Council November Meeting Slides
DDRS Advisory Council November Meeting Data
DDRS Advisory Council October Meeting Slides
DDRS Advisory Council October Meeting Data
DDRS Advisory Council September Meeting Slides
DDRS Advisory Council August Meeting Slides
A&D Waiver Transition to H&W Waiver Webinars Hosted by DDRS
5/1/2024 Webinar Recording Link
5/15/2024 Webinar Recording Link
5/29/2024 Webinar Recording Link
6/12/2024 Webinar Recording Link
6/26/2024 Webinar Recording Link
7/10/24 Webinar Recording Link
FSSA clarifies that SFC & HHS cannot be provided by same paid caregiver
FSSA updated Structured Family Caregiving FAQ – June 18, 2024
Care managers will not use an evaluation tool to determine the SFC tier level for children, at this time. The SFC tier level will be based on authorized attendant care hours as of May 1:
- SFC Level One: 1-20 hours/week
- SFC Level Two: 21-40 hours/week
- SFC Level Three: 41+ hours/week
FSSA has received approval from the Centers for Medicare and Medicaid Services (CMS) for eligible individuals to be able to receive skilled respite while receiving SFC. This is in addition to the 15 days per calendar year of unskilled respite available within SFC. Foster parents are also approved to provide SFC.
The Arc of Indiana Webinars
Ask The Arc – Finalized 2024 Medicaid Waiver Changes – 6.14.24
Ask The Arc – Structured Family Caregiving Session I
Kelli Tungate and Lisa Bennett from Careforth, Indiana’s largest Structured Family Caregiving provider agency, discuss how Structured Family Caregiving works and what families should think about when considering Structured Family Caregiving.
Webinar Video
Webinar Slides
Ask The Arc – Structured Family Cargiving Session II
Evan Reinhardt, executive director, Indiana Association of Home and Hospice Care, talks about Structured Family Caregiving and the role that home health services can play in serving individuals on the Health & Wellness, Pathways for Aging, and TBI Waivers. He also gives an overview of the training requirements for home health aides so families know what the aides’ qualifications are and if they want to explore becoming a home health aide for their loved one.
Webinar Video
Webinar Slides
4.3.24 – Cost-share Restart: July 1, 2024. During the COVID-19 public health emergency, Indiana paused Medicaid cost sharing. This will end July 1, 2024, and Indiana will restart cost sharing for Medicaid, including the Healthy Indiana Plan (HIP), Children’s Health Insurance Program (CHIP); and MEDWorks program for employed individuals with a disability. Click here for information.
Webinars hosted by The Arc of Indiana on February 8 and February 12 provide information on changes to Indiana’s TBI, CIH and Family Supports Waivers and information on the new H&W and Pathways to Aging Waivers.
Medicaid Waiver Changes Webinar I
Medicaid Waiver Changes Webinar II
DDRS Slides