2024 Medicaid & Medicaid Waiver Changes
Updates and information on changes being made to Medicaid and Medicaid Waivers in Indiana
A&D Waiver Transition to H&W Waiver Webinars
FSSA is hosting a series of webinars regarding the transition of the Aged & Disabled Waiver to the Health & Wellness Waiver for individuals 59 years and younger, effective July 1, 2024. Please note these webinars will not include information for current Aged & Disabled Waiver recipients who are 60 and older who will transition to the PathWays for Aging Waiver. The webinars will be recorded and made available to those who cannot attend. Each webinar will take place from 3:00-3:30 p.m. ET.
Following are links to join a webinar. Registration is not required.
For specific information and questions regarding the transition, visit in.gov/fssa/medicaid-strategies.
Structured Family Caregiving Webinars
With changes coming to the new Health & Wellness and Pathways for Aging (currently A&D) and TBI Waivers, many families have questions about Structured Family Caregiving. These two webinars provide information on this service.
4.9.24 – Ask The Arc – Structured Family Caregiving Session I
Kelli Tungate and Lisa Bennett from Careforth, Indiana’s largest Structured Family Caregiving provider agency, discuss how Structured Family Caregiving works and what families should think about when considering Structured Family Caregiving.
Webinar Video
Webinar Slides
4.11.24 – Ask The Arc – Structured Family Cargiving Session II
Evan Reinhardt, executive director, Indiana Association of Home and Hospice Care, talks about Structured Family Caregiving and the role that home health services can play in serving individuals on the Health & Wellness, Pathways for Aging, and TBI Waivers. He also gives an overview of the training requirements for home health aides so families know what the aides’ qualifications are and if they want to explore becoming a home health aide for their loved one.
Webinar Video
Webinar Slides
4.3.24 – Waiting list started for Aged & Disabled Waiver (Health & Wellness effective July 1, 2024)
Link to information on what happens when you are added to the waiting list.
4.3.24 – Cost-share Restart: July 1, 2024. During the COVID-19 public health emergency, Indiana paused Medicaid cost sharing. This will end July 1, 2024, and Indiana will restart cost sharing for Medicaid, including the Healthy Indiana Plan (HIP), Children’s Health Insurance Program (CHIP); and MEDWorks program for employed individuals with a disability. Click here for information.
Medicaid Waiver Amendments
On January 17, 2024, the Family and Social Services Administration (FSSA) submitted new waiver amendments to the Centers for Medicare and Medicaid Services (CMS) for the proposed Pathways for Aging, Community Integration and Habilitation (CIH), Family Supports (FSW), Traumatic Brain Injury (TBI), and Health and Wellness (H&W) waivers – currently the Aged & Disabled (A&D) waiver.
While not authorized in the current A&D waiver*, the practice has been to allow Legally Responsible Individuals (LRIs) – parents of a minor and spouses – and legal guardians to serve as paid personal care attendants (PCAs).
CMS allows states to pay LRIs through a Medicaid Waiver; however, as proposed, the H&W Waiver and TBI Waivers would not allow LRI’s to be paid to provide attendant care. Instead, LRI’s would be required to transition to Indiana’s Structured Family Caregiving program. New guidance issued January 26th clarifies that legal guardians of adults can be paid to provide PCA up to 40 hours a week.
This will negatively impact families caring for medically fragile children with significant disabilities.
We are working with FSSA and talking with state leaders and legislators to identify areas to help bring Medicaid costs into alignment while minimizing the impact on people with disabilities and their families.
The Arc of Indiana Public Comments on Proposed Changes
Family Supports Waiver Public Comments
CIH Waiver Public Comments
TBI Waiver Public Comments
Health and Wellness Waiver Public Comments
Pathways to Aging Public Comments
Lt. Governor Crouch letter to FSSA – 2/20/24
Medicaid Waivers – Who can be paid for what services charts – 2/22/24
Fact Sheet: Why is This Happening
Updated 1/30/24
Fact Sheet: Families as Personal Care Attendants
Updated 1/30/24
Fact Sheet: Nursing Services
Updated 1/30/24
Fact sheet: Structured Family Caregiving
FSSA side-by-side comparison of Structured Family Caregiving and Attendant Care – 2/14/24
FSSA Attendant Care and Structured Family Caregiving Relationship Guidance – 1/26/44
*Click here to view A&D Waiver Attendant Care Services Activities Not Allowed
2024 Medicaid Waiver Changes Webinar – 2/8/24
2024 Medicaid Waiver Changes Webinar – 2/12/24
DDRS Slides
The February 8 and February 12 webinars provide information on proposed changes to Indiana’s TBI, CIH and Family Supports Waivers and information on the new Health & Wellness and Pathways to Aging Waivers. The DDRS slides provide information on changes made from when the waiver amendments were first open for public comment in Nov./Dec. 2023.
Slides – Intellectual and Developmental Disabilities Task Force – 1/29/24
FSSA – New Guidance Issued January 26, 2024