October 1st has come and gone and major components of the Affordable Care Act (ACA) are continuing to move forward. Changes to Medicaid and Marketplace enrollment processes and procedures in Indiana have begun and the new coverage options become effective January 1st, 2014.  As part of our ongoing commitment to our clients, we continue announce several enhanced services that will ensure you have the information and resources needed throughout this transition. Our goal remains to provide you and your patients / clients / consumers with the ClaimAid Advantage.

Application Organizations and Hospital/Health Care Provider Requirements

  • Effective October 1, 2014, Title 27 of the Indiana Code requires organizations meeting the definition of “Application Organization” in IC 27-19-2-3, to become certified by the State of Indiana.
  • What you need to know: If your organization contracts Medicaid and Marketplace enrollment assistance with ClaimAid, your organization IS NOT REQUIRED to certify as an Application Organization (AO). All other organizations that directly employee staff who perform Navigator functions must meet the certification and compliance standards. If you don’t contract this work, or still have a few employees that require certification, ClaimAid can ensure that your organization remains compliance with our Application Organization Management Service (AOM). The affordable subscription service provides your team with the education, tools, and support they need to ensure that they keep up with the latest regulations. If you would like more information about this service, please let us know.


The Health Insurance Marketplace

  • On October 1st, 2013 the Health Insurance Marketplace opened and there have been some initial technical problems with enrollment.
  • What you need to know:  The system is improving. We have been closely monitoring and testing the Marketplace system with increasing success. It remains our expectation that the system will eventually provide the Advanced Premium Tax Credit (APTC) information and Qualified Health Plan (QHP) information that we anticipate. The deadline to enroll in coverage that becomes effective January 1st, 2014 is December 15th, 2013, so there is still time to reconcile system issues.


The Healthy Indiana Plan

  • The Healthy Indian Plan has been extended for 1 year, with major changes to eligibility requirements effective January 1, 2014. HIP Income eligibility is reduced from 200% to 100% of FPL.
  • What you need to know:  Individuals who are presently enrolled in HIP at <100% FPL will continue on the program, but those enrolled who are >100%FPL are receiving notice that coverage will end on December 31st, 2013. Those individuals currently on the “waiting list” are required to reapply due to the changes in program eligibility.


Indiana Medicaid and Federal System Integration

  • As of the October 1st, 2013 launch, the Health Insurance Marketplace and Indiana Medicaid systems have not been properly “transferring” information.
  • What you need to know:  According to the Indiana Office of Medicaid Policy and Planning (OMPP), this problem is scheduled to be resolved by mid-November. ClaimAid staff will continue to enroll individuals into the system that is most appropriate, based on our assessment of the patient, in order to facilitate an efficient process.

For more details and up-to-date information, please contact J Hopkins, Vice President at 800.842.4052 x126 or by email at jhopkins@claimaid.com.