As previously announced in Indiana Health Coverage Programs (IHCP) Bulletin BT202394, the Indiana Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning (OMPP) has requested that all managed care entities (MCEs) that provide Healthy Indiana Plan (HIP) coverage reprocess denied Medicare coinsurance claims. This only affects Medicare coinsurance and deductible claims for members who became Medicare-eligible during the public health emergency (PHE) and were members of both Medicare and HIP for dates of service (DOS) on or after March 1, 2020.

MCEs are being instructed to appropriately reprocess HIP claims for dually eligible members with DOS on or after March 1, 2020, that were denied. MCEs are also being instructed to continue paying Medicare coinsurance and deductible claims for dually eligible HIP members through May 1, 2024, when the PHE unwind redetermination process is completed for these members. 

Providers serving HIP members, including federally qualified health centers (FQHCs) and rural health clinics (RHCs), who submitted claims for coinsurance and deductibles using procedure codes that did not match the codes on the Medicare remittance, will need to resubmit corrected claims to the MCE for payment. Please follow the MCE’s guidelines for submitting corrected claims, with this bulletin attached for waiving the timely filing. Timely filing will be waived for 90 days from Oct. 5.

Read more in BT2023131.

IHCP requests feedback on its website
To ensure providers feel confident in locating the information they need to be successful, the IHCP would like to gather feedback on the usability and organization of its website. Providers may click on and complete an eight-question survey regarding the website by Oct. 31. It should take no more than 10 minutes to complete the survey and all responses will be kept anonymous. 

Read more in IHCP BT2023120.