Waiver amendment and 1915 (b)(4) application update

The Division of Disability and Rehabilitative Services Bureau of Developmental Disabilities Services is pleased to share the amendments to both Home-and Community Based Services waivers, the Community Integration and Habilitation waiver and Family Supports waiver, were recently approved by the Centers for Medicare and Medicaid Services. Additionally, CMS approved a new 1915 (b)(4) selective contracting waiver for case management services, which will operate concurrently with the CIH and FS waivers. The effective date of all three waivers is Jan. 1, 2022.

Many of the changes and updates being implemented in January are the result of active stakeholder engagement and feedback the bureau has received from individuals, families and our industry partners.

The approved amendments include:

• several enhancements to service definition descriptions,
• expansion of several allowable/reimbursable activities, and
• permanent adoption of the rate increases applicable to specific FSW/CIH services and previously approved under the Appendix K temporary flexibilities as of July 1, 2021.

The complete, approved waiver documents can be found on the BDDS webpage.  

Highlighted changes across both CIH and FS waivers:

• Case management service provided by 1915 b(4) waiver to establish selective contracting with qualified case management companies.
• As authorized and directed by the Indiana legislature’s 2021 approved budget bill, BDDS will continue to provide the 14% rate increase initiated as of July 1, 2021, as part of Appendix K
• Case management - service definition revised and enhanced to add clarity.
• Remote supports - service definition and provider qualifications clarified.
• Separation of vehicle modifications from specialized medical equipment and supplies services, creating two standalone services with their own separate cap limits.
• Vehicle modifications will include $15,000 cap every 10 years with expanded modification allowances

  FS waiver only:

• FS waiver cap - increased from $17,300 to $19,614
• Transportation - annual service limits increased for each level of non-medical transportation

The DDRS HCBS Provider Module is currently being updated to reflect the approved waivers and will be announced once complete.