Here are the changes coming to Indiana Medicaid programs for Hoosiers needing at-home care
Major changes are coming to Hoosier families who depend on the state's Medicaid program for services for medically-complex children and support for aging family members.
The changes to reimbursement rates, eligibility to provide care for family members and insurance takeover over of some administrative roles have spurred waves of activism and resistance from families and nonprofits worried that services will deteriorate under the new programs. Compounding the problem, they say, they have had limited time to adjust to the changes.
While some changes have been planned for some time, other cuts were tied to a $1 billion shortfall that state officials forecasted for the program.
"Our sustainability strategies were announced in January as a result of the December 2023 forecasts variance," said Cora Steinmetz, director in the office of Medicaid policy and planning, during a Monday press conference. "We've taken additional steps as an agency to make sure a variance of this magnitude never happens again."
Reimbursements are decreasing for families
Hooisers who were getting paid hourly through Medicaid to care for family members with medical needs will no longer collect that payment.
Families have expressed outrage at the change, especially as a provider shortage has made it hard to hire outside help.
The state's Family and Social Services Administration created another model, in which the state pays a professional service provider a daily stipend. Family members could collect a portion of the payment, a steep cut compared to the previous rate.
Indiana Disability Rights and the ACLU of Indiana filed a federal lawsuit in May to force the state to continue its hourly payment to family caretakers.
Insurance companies taking over care management
Three insurance companies — Anthem Blue Cross and Blue Shield, United Healthcare Community Plan and Humana Health Horizons of Indiana — will take over some management of care for aging Hoosiers on Medicaid, cutting payments to nonprofits that previously did this work.
This change means that some people will have the option between their local nonprofit, such as CICOA Aging and IN-Home Solutions, or an insurance company.
Numerous Area Agencies on Aging officials across the state said the reductions in payment will result in programming cuts that will hurt the senior community.
Waiting lists for stay-at-home care
Hoosiers who qualify for a Medicaid program that reimburses for care provided at home will now have to apply through two new programs.
Those 60 and older will apply to the Pathways for Aging Waiver. That program has nearly 40,000 spots and about 9,000 people on the waitlist.
Those 59 and younger will apply to the Health and Wellness Waiver. That program has some 16,000 spots and nearly 3,800 on the waitlist.
Binghui Huang can be reached at 317-385-1595 or Bhuang@gannett.com
This article originally appeared on Indianapolis Star: Hoosiers who are disabled will see changes to Medicaid benefits July 1.
