Changes To HIP
The US Centers for Medicare and Medicaid Services (CMS) approved the Healthy Indiana Plan for an additional three years.
Following is information about the renewed plan provided by FSSA:
To help ensure Indiana has a healthy workforce, starting in 2019 participation in the Gateway to Work program will be required for some HIP members. Unless they fall into one of several exempt categories, such as being medically frail, pregnant, in treatment for substance use or having a child younger than school age to take care of, HIP members will be required to work, go to school, volunteer or participate in other qualifying activities up to 20 hours a week. Members required to participate will need to meet these requirements for at least 8 out 12 months of the year. More information will be shared with stakeholders about this initiative in the coming months.
Adds new benefits and approximately $80 million in annual funding authority for substance use disorder treatment for members struggling with addictions. These benefits will be available for anyone on Medicaid, not just HIP members.
POWER Accounts, deductibles and member’s health plan choices will now be done according to the calendar year for all members.
Making monthly contributions to their POWER Accounts will be simpler and more predictable for members. Instead of a unique amount calculated monthly for each member, contributions will be one of five simple, defined amounts.
Chiropractic benefits are being added for HIP Plus members to go along with the vision and dental benefits already available.
Pregnant members will stay in HIP when pregnant and move into HIP Maternity. They will receive enhanced benefits and will not be subject to cost sharing.
HIP will increase efforts to help members stop smoking and using tobacco. HIP will offer new and enhanced incentives for members to access tobacco cessation medications and treatments. Members who use tobacco will have a year of HIP coverage to stop tobacco use or have a 50 percent higher POWER Account contribution
For each non-emergency visit to the emergency room members will be charged a $8 copay. There will no longer be a $25 copayment charged for subsequent visits.
Members who do not participate in their annual eligibility redetermination process will not be able to reenroll for six months following termination of benefits. If members comply within three months of their redetermination date, benefits will be restored.
For the most part, day-to-day HIP program operations are staying the same. Applications will continue to be received year-round and eligibility determinations made throughout the year. HIP Plus continues to be the plan option that will provide the best value and most consistency for members, especially considering the new five-tier POWER Account contribution scale.
The Office of Medicaid Policy and Planning will offer stakeholders and navigators a training session and waiver overview on Friday, February 16, 1:30 – 3:00 in the Indiana State Government Center South auditorium.
A live webinar will also be available at:https://Indiana.
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