FSSA proposes Behavioral and Primary Healthcare Coordination program

Family Voices Indiana shares the following bulletin from Indiana Health Coverage Programs:

The Indiana Family and Social Services Administration (FSSA), through its Division of Mental Health and Addiction 

(DMHA) and Office of Medicaid Policy and Planning (OMPP), is proposing an amendment to the Indiana Medicaid State Plan to implement a new 1915(i) Home and Community-Based Services (HCBS) program. 

The program, Behavioral and Primary Healthcare Coordination (BPHC), will be used to coordinate healthcare services for individuals with mental illness and has a proposed effective date of June 1, 2014, pending federal approval. 

BPHC is designed to assist individuals with serious mental illnesses who do not otherwise qualify for Medicaid and do not have other third-party insurance coverage for the level of services they need to function safely in the community. 

The BPHC program will provide supportive and intensive community-based services to individuals who demonstrate 

impairment in self-managing their healthcare needs due to mental illness. 

Potentially eligible individuals include those who are 19 years of age or older, have been diagnosed with mental health conditions, and have incomes below 300% of the federal poverty level. Individuals eligible for BPHC would include those who currently qualify for Medicaid with a spend-down but who will possibly lose Medicaid coverage when the State implements disability eligibility changes in June 2014 (see the related News Summary posted January 30, 2014, at indianamedicaid.com). 

IHCP members, who were identified as potentially affected, have been notified in writing of the upcoming eligibility changes. These members have been encouraged to apply for BPHC at local community mental health centers no later than April 1, 2014, to prevent a gap in coverage. 

The BPHC program will not provide behavioral and primary healthcare services directly to enrolled individuals. Rather, 

the program is designed to assist members in coordinating these needed services through Medicaid and other 

complementary programs. Units of service through BPHC will be reimbursed in conjunction with receipt of other 

healthcare services. 

More information about the BPHC program, the proposed state plan amendment (SPA), and the proposed rules can be found on the FSSA website at in.gov/fssa.