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Showing posts from June 5, 2016

FSSA announces managed care contractors selected to serve Healthy Indiana Plan and Hoosier Healthwise members

Indianapolis (June 10, 2016) – The Indiana Family and Social Services Administration (FSSA) today announced the selection of Anthem Blue Cross and Blue Shield, CareSource Indiana, MDwise Inc. and Managed Health Services of Indiana to negotiate contracts to administer health care services for the approximately 1,000,000 enrollees in the Healthy Indiana Plan and Hoosier Healthwise programs starting  January 1, 2017 . The contracts would be effective for a maximum of six years. In procuring the selected vendors, FSSA made a number of enhancements to the contracts to improve the value Hoosier taxpayers receive for the dollars spent in the Medicaid managed care entity (MCE) contracts including:  Significantly increasing the payment tied to outcomes to further incentivize the MCEs to improve the health of the populations served. The contracts do this by progressively increasing the payment amount withheld and awarded based on outcomes from 2 percent in the first year to 5 percent in ye

Support Family Voices Indiana When You Shop at Kroger!

Do you shop at Kroger? Do you know you can support Family Voices Indiana through their Community Rewards Program? If you shop at Kroger and use their reward card – Kroger will contribute 2% of your purchase. It doesn't cost YOU a cent! All you have to do is select Family Voices Indiana, #   60866 ,  by going here: As a small not for profit, we appreciate any and all donations. Thank you for your support! If you need more information, here are step by step instructions: Simply register online at Be sure to have your Kroger Plus card handy and register your card with your organization after you sign up. If you do not yet have a Kroger Plus card, they are available at the customer service desk at any Kroger. Click on Sign In/Register If you are a new online customer, you must click on SIGN UP TODAY in the ‘New Customer?’ box. Sign up for a Kroger Rewards Account by entering zi

Vision and Hearing Services under Medicaid

The Centers for Medicare and Medicaid Services (CMS) and its partner agencies have been working to improve guidance regarding Medicaid coverage of vision and hearing services for children. CMS has now posted these webpages:  Vision and Hearing Screening Services for Children & Adolescents Vision :  At a minimum, diagnosis and treatment for defects in vision, including eyeglasses. Vision services must be provided according to a distinct periodicity schedule developed by the state and at other intervals as medically necessary. Hearing :  At a minimum, hearing services include diagnosis and treatment for defects in hearing, including hearing aids. Steps States Can Take to Ensure Children and Adolescents Receive Vision Services   The  EPSDT  page on has been updated to include links to the Vision and Hearing page.

Health Insurance Appeals Rights and Processes

From the Centers for Medicare and Medicaid Services (CMS):  Internal Claims and Appeals and External Review Processes Overview  is a set of slides providing information about a consumer's right to appeal health insurance plan decisions under the Affordable Care Act, including the right to ask that an issuer reconsider its decision to deny payment for a service or treatment, or to rescind coverage. The slides describe: What issuer decisions can be appealed How long consumers have to initiate appeals How consumers must document and submit appeals How consumers can request an expedited appeal timeline in urgent care situations When and how to request an external review by state or federal authorities These appeal rights and processes apply to consumers enrolled in non-grandfathered qualified health plans through a Health Insurance Marketplace.  From Families USA:  When a Bill Becomes a Coverage Appeal: A Basic Overview  is an archived webinar (slides and audio; abou

Taking Care of YOU by Jan Labas

June can be a month of transitions.  Our children are finishing school and starting new routines which means that we as parents are doing the same.  For some, the onset of summer vacation is a relief from the early mornings of getting ready for school and for others it can be a terrifying change of having your children home with you all day and wondering how you will k No matter how summer vacation finds you, it is important to remember to take care of yourself.  Summer often means the demands on our time are increased which can lead to us being even more tired and stressed than the normal rhythm of the year. Respite is an available service under the Medicaid Waiver program.  This offers one way to take care of yourself.  These hours can’t be used for a parent to go to work or school. They are intended to give us a needed break to recharge our parental batteries. When my children were younger I was awful at this.  I thought no one could do things for my child the way I

Action Alert: Contact Your Legislators about Home Health Care Rate Cuts

from Hearts for Home Advocacy Center: A major reduction in Medicaid reimbursement for home health care services will be implemented on July 1 unless immediate action is taken by the Governor’s Office.  The Office of Medicaid Policy and Planning (OMPP) and the Family and Social Services Administration (FSSA) is implementing a devastating reduction in reimbursement that totals $20 million dollars on top of an existing 3% emergency rate cut.  This continues a decade-long trend to decrease home care reimbursement for over almost a decade – the proposed rates for 2017 are lower than home care providers received in 2010! Without adequate reimbursement home care our agencies across the state cannot attract and retain qualified professionals to provide needed client services. Current reimbursement rates have resulted in access problems for clients.  This significant new reduction in reimbursement will further jeopardize access to critical services for our clients.  Home health care all

What Parents of Children with Disabilities Need to Know about Changes in the ACA

The Department of Health and Human Services issued some new rules for health plans sold in the federal exchange next year.  This is good news, as these changes will give consumers more information about health plans and make it easier to compare plans.  Kaiser Health News  recently reported on three major changes that consumers will see.    Please note that these changes apply only to the 38 states using the federal exchange. Additional information on the networks of plans Families will now have more information on which providers and hospitals are in their plan’s network.  Besides the cost of the plan, most parents are concerned if their child’s doctor or hospital is participating in the plan.  The new change would require 30 days’ notice if a provider is leaving the plan.  In addition, if a child is undergoing treatment, coverage of the provider must continue for 90 days to avoid interruption of service.  The only exception is if the provider is being “dropped for cause.”  Con