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Health Plan Programs
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Each state develops a state plan, which is a comprehensive written commitment by a Medicaid agency to administer or supervise the administration of a Medicaid program, in accordance with federal and state requirements.
The Indiana requirements are contained in the Indiana Code (IC) and the Indiana Administrative Code (IAC).
States may elect to administer the Medicaid program themselves or enter into contractual agreements with outside entities to administer the program.
The Office of Medicaid Policy and Planning (OMPP) is the office within Indiana Family and Social Services Administration (IFSSA) that administers the Indiana Health
Coverage Programs, including the health plan programs. The OMPP has the final responsibility for all program policies and coordination with other state and federal
agencies as required.
The State of Indiana has contractual agreements with the following entities to support and administer the health plan component
of the IHCP:
- Fiscal Agent
- Surveillance and Utilization Review Contractor
- Enrollment Broker
- Managed Care Organizations (MCOs)
- Monitoring Contractor
- Care Management Organizations (CMOs)
- Healthy Indiana Plan Insurers
The State of Indiana has developed the health plan programs outlined below:
Hoosier Healthwise
During the summer of 1994, the OMPP, under a federally approved Section 1915(b) waiver, implemented a mandatory managed care program, known as Hoosier Healthwise, Risk Based Managed Care (RBMC), covering low income families, children and pregnant women.
The program is managed by the State's contracted Managed Care Organizations (MCOs). To learn more specific information regarding this program, please
view the Hoosier Healthwise - RBMC Home page.
Medicaid Select
As of March 1, 2008, Medicaid Select is no longer an IHCP program. All Medicaid Select
providers were provided the option to contract as a Care Select
provider. Medicaid Select members were transitioned into the Care Select
program with the exception of dual eligible members. Dual eligible members were transitioned into the Medicaid Traditional program.
Hoosier Healthwise PCCM or PrimeStep
As of January 1, 2006 PCCM or PrimeStep is no longer a Hoosier Healthwise program. PCCM providers and members have been transitioned into the Risk Based Managed Care (RBMC).
Care Select
The State of Indiana has created a care management program, Care Select, to serve the population of the aged,
blind, disabled including the members in the waiver program, members receiving adoption assistance,
and non-institutional members in the hospice program. The Care Select program is managed by the Care Management Organizations (CMOs).
To learn more specific details regarding this program, please view the Care Select Home page.
Healthy Indiana Plan (HIP)
The Healthy Indiana Plan (HIP) is a program sponsored by the State of Indiana, that provides a more affordable health care choice to thousands of otherwise uninsured individuals throughout Indiana. HIP provides health insurance for uninsured adult Hoosiers between the ages of 19 and 64 whose income is up to 200 percent of the federal poverty level (FPL), and who are not otherwise eligible for Medicaid. Unlike many other government sponsored programs, parents and childless adults can participate. Eligible participants must be uninsured for at least six months and cannot have access to employer sponsored health insurance. Participants are required to make monthly contributions toward coverage.
To learn more specific details regarding this program, please view the Healthy Indiana Plan Home page.
Associated Links
To learn more about the details of all the Health Plan Programs, please follow the links through the following topics:
We would like to know what you think of our Health Plan site information. Please tell us what you think.
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