IHCP Clarifies PE for Incarcerated Individuals

Please carefully read the IHCP bulletin that clarifies presumptive eligibility for incarcerated individuals.  The information in the bulletin is different from what we understood from previous written directives and training material from FSSA. Note: This bulletin provides descriptions and examples of incarceration vs. non-incarceration which could result in an inmate PE vs. a regular PE. […]

MDwise leaving Hoosier Care Connect

IHCP recently announced that beginning April 1, 2017, MDwise will no longer be a managed care health plan option for Hoosier Care Connect members. Hoosier Care Connect members currently enrolled with MDwise have already started receiving notices from the Office of Medicaid Policy and Planning informing them of this change. Read the full IHCP bulletin […]

What should I do if HPE coverage terminates incorrectly?

We have heard from some of you that recently HPE members’ temporary coverage is being terminated at the end of the month following the HPE approval despite their timely filed full applications either remaining in pending or conditional status.  OMPP has been made aware of this and will be researching the cause. If this occurs […]

What does the “Medical Review Team” note in CoreMMIS mean?

Question: If you are verifying eligibility for a patient in the new CoreMMIS Portal and you see “Medical Review Team” displayed under the Coverage section, what does that mean? a)  The patient is enrolled in Medicaid for the Disabled b)  The patient is being evaluated for IHCP eligibility c)  You need to call the Medical Review […]

Industry Updates: Qualified Provider HPE Metrics, CareSource, CoreMMIS, and MDwise Leaving Hoosier Care Connect

Qualified Provider (QP) Hospital Presumptive Eligibility (HPE) Metrics In the last quarter of 2016, letters were distributed by the state of Indiana FSSA to all acute care and psychiatric hospitals contracted as Qualified Providers (QPs) with the Medicaid Presumptive Eligibility (PE) program. These letters served as a “first warning” of non-compliance with state metrics and […]