Indiana Health Coverage Programs got CMS approval to progress with an enrollment and certification moratorium for some Medicaid providers beginning Aug. 1.
According to a July 23 bulletin, the freeze will continue for six months. IHCP can extend the pause in six-month increments.
The moratorium will target home- and community-based services 1915(c) waiver providers. Affected services include those under Indiana PathWays for Aging, Health and Wellness, Traumatic Brain Injury, Community Integration and Habilitation, and Family Supports waivers. Some services subject to the moratorium include music therapy, home-delivered meals, adult family care, workplace assistance and transportation.
PathWays, Health and Wellness, and Traumatic Brain Injury waiver certification applications currently under review will be processed, but those that are newly submitted or awaiting review will expire. Certification applications currently under review for Community Integration and Habilitation and Family Supports waivers will expire. Applicants can reapply after the pause.
Screening requirements for IHCP must be done before Aug. 1 to be enrolled during the moratorium.
Under federal regulations, a state Medicaid agency can establish a temporary freeze on new provider enrollment if there is “a significant risk for fraud, waste or abuse” identified by the state agency and HHS, the bulletin said. IHCP said it would consider some moratorium exceptions “to ensure sufficient member access to waiver services to areas in need.”
In June, the Indiana Family and Social Services Administration — which manages IHCP — announced a six-month moratorium for new applied behavior analysis provider agencies. The moves build on a nationwide crackdown targeting fraud, waste and abuse in government healthcare programs. Another recent development took place earlier in July, when HHS deferred $1 billion in federal Medicaid funds to Minnesota and California.
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