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 […]

FSSA Contact Pages

FSSA has a contact page on their website where you can submit inquiries or information related to a case. Some items you may inquire about are: Status of an application HIP POWER account payment confirmation Correcting HIP effective dates Reporting changes Some Advocates have had success in resolving issues with application by submitted inquiries though […]

New ACTS HIP Jail Suspended Reason

In response to popular demand, we’ve now added a HIP Jail Suspended Reason to the HIP Approval T-Code that should be used for ALL cases where an applicant receives the “…your HIP Application has been suspended because…” letter. Please have ALL of these accounts currently in PENDED status updated with this so that they will […]

Marketplace Special Enrollment Periods

  After Jan 31, consumers would need to qualify for a special enrollment period (SEP) in order to sign up for health coverage through the Marketplace. Consumers may be granted a SEP for certain life events that result in a change in family status or loss of other health coverage.  Consumers usually have up to 60 […]

CoreMMIS Set to Launch February 13th

  The Indiana Health Coverage Programs (IHCP) announced this week that it plans to launch the new CoreMMIS processing system on February 13, 2017. CoreMMIS is a modernized system that IHCP hopes will provide greater accuracy and efficiency in processing claims for services in alignment with coverage policies and national billing guidelines. With the new system, […]