Home and community-based services rate increase amendments approval by CMS

October 19, 2023

Home and community-based services rate increase amendments approval by CMS

The Division of Disability and Rehabilitative Services and Bureau of Disability Services are pleased to announce that our federal partners at the Centers for Medicare and Medicaid Services approved the proposed home and community-based services waiver rate increases retroactive to July 1, 2023. We continue to be encouraged by the support for this strategic priority from stakeholders, legislators, and our federal partners as we’ve advanced the work throughout 2023.

For individuals utilizing BDS services, the CMS-approved rate increase approval impacts the Family Supports and Community Integration and Habilitation waivers. For individuals on the FSW, the annual cap has been adjusted to $26,482 to accommodate the increased rates. Individuals on the FSW will receive the full capped amount during their current plan year. For individuals on the CIH and MFP-CIH waivers, their objective based allocation will be recalculated adjusting for the new rates while following the method for calculation in 460 IAC 13.

Guidance outlined in the June 6 and July 11 IHCP bulletins (BT202359 and BT202378) asked providers to begin billing with the new rates for claims with dates of services on or after July 1, 2023. For providers who began using the new rates as requested, Gainwell Technologies will implement a mass adjustment of all appropriate claims. Once all systems have been updated to reflect the new approved rates, these claims will automatically be reprocessed, and providers will be paid the difference between the old and new rates.

Beginning Thursday, Oct. 19,2023, at 6 p.m. ET the BDS Portal will be unavailable to allow for system changes to occur. We anticipate the BDS Portal will be available on Monday, Oct. 23, 2023, at 8 a.m. ET. At that time providers and case managers will have access to updated PCISPs that reflect the new rates. PCISPs with a service or services that start prior to and end on or after July 1, will show the same service(s) listed twice on the PCISP. This is to account for calculations of the service(s) included on the plan with the rates that were effective through June 30, 2023, as well as the service(s) and rates effective July 1, 2023, and after. SA/NOA generation and distribution will occur over the span of Oct. 23, 2023 – Nov. 13, 2023.

Providers and case managers should submit Jira tickets if any issues are noticed on Oct. 23, 2023 (or after) related to rate changes that were processed.

Providers can access all Indiana Medicaid bulletins and banners on this webpage.