Families have begun reporting that they are being told that for Medicaid members receiving Medicaid Waiver services and home health services, the direct care staff person for each service cannot be the same individual. Please note that this does not exclusively affect Attendant Care and Structured Family Care (SFC). It pertains to all waiver services.
The Arc of Indiana has verified the source of this information.
The notice was originally linked within several layers in an Indiana Health Coverage Programs (IHCP) Update, sent on Friday, December 12, 2025, at 1:04 p.m.
The reference is published in the Medicaid Home Health Manual, updated 12-9-25. https://www.in.gov/medicaid/providers/files/modules/home-health-services.pdf
The relevant information is on pages four and five. and is bolded in the bullet points below.
Coordinating Home Health Services With Attendant Care and Structured Family Caregiving for HCBS Waiver Members
The following clarification is provided so that providers do not duplicate services for home health members who are also eligible for Attendant Care or Structured Family Caregiving services under an HCBS waiver:
- Home health services may be provided on the same day as Structured Family Caregiving if the services are not rendered at the same time (simultaneously).
- Home health services may be provided on the same day as Attendant Care services if the services are not rendered at the same time (simultaneously).
- For members receiving both Structured Family Caregiving and home health services, the direct care provider for each service cannot be the same individual.
- Home health services are not reimbursable if the individual’s primary caregiver (whether paid or unpaid) is a paid provider of another Medicaid service – including Attendant Care and other HCBS waiver services – for that same individual. This is because home health reimbursement is allowable only when the primary caregivers are unavailable, and the caregiver cannot make themselves unavailable to allow the individual to qualify for home health services.
- Home health providers that provide services to a member residing in an assisted living facility must verify that the home health services are not duplicative of the services the assisted living facility is required to provide under room and board (see the Additional PA Requirements for Assisted Living Facility Residents section).
Home Health Services Library Reference Number: PROMOD00032
Published: Dec. 9, 2025
Policies and procedures as of April 1, 2025
Version: 8.0