Report

Indiana: External Quality Review of Indiana’s Hoosier Healthwise Program and Healthy Indiana Plan for the Review Year Calendar Year 2014

Published by Burns & Associates Inc. Health Policy Consultants

As the state agencies responsible for Indiana’s Medicaid program, the Family and Social Services Administration (FSSA) and the Indiana Office of Medicaid Policy and Planning (OMPP) have implemented two managed care programs using Section 1115 waiver authority. The Hoosier Healthwise (HHW) program, which began in 1994, covers children, pregnant women, and low-income families. The Healthy Indiana Plan (HIP), which began in 2008, covered custodial parents, noncustodial parents and childless adults ages 19 through 64 with family income up to 200 percent of the Federal Poverty Level who were not otherwise eligible for Medicare or Medicaid during Calendar Year (CY) 2014. In January 2015, the State received waiver authority from the Centers for Medicare and Medicaid (CMS) to change the design of HIP (often called HIP 1.0) to a non-traditional Medicaid model (called HIP 2.0) that effectively terminated HIP 1.0 on January 31, 2015. Since this year’s External Quality Review (EQR) covers the Review Year of CY 2014, only HIP 1.0 was reviewed in this year’s EQR.

Publication Date: 2016

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Source: Burns & Associates. External Quality Review of Indiana’s Lose Year Healthwise Program and Healthy Indiana Plan For The Review Year Calendar Year 2014. Report to the Indiana Office of Medicaid Policy and Planning. Phoenix, AZ: Burns & Associates, 2016.