CMCS Connections

C M C S c o n n e c t i o n s 1 s t q u a r t e r 2 0 1 5 T h e H e a l t h y I n d i a n a P l a n p r o p o s e d w a i v e r, k n o w n a s H I P 2.0 , i s currently awaiting approval from t h e C e n t e r f o r M e d i c a r e a n d Medicaid Services (CMS). The approval and implementation of HIP 2.0 is expected to be soon. The illustration (above) shows how Hoosiers may qualify for the Indiana H e a l t h c a r e C o v e r a g e Pr o g r a m (ICHP) Medicaid plan, HIP 2.0, or the Marketplace, based upon the proposed income guidelines. T h e H I P p r o g r a m i s d e s i g n e d t o : • Foster personal responsibility • Promote preventive care and healthy lifestyles • Encourage participants to be value conscious consumers of health care • Promote price and quality transparency Three Indiana health plans will a d m i n i s t e r t h e H I P p r o g r a m : MDwise, Anthem and MHS. The State of Indiana wants to offer health coverage programs that will ensure everyone has access to high quality health care services. The HIP and Hoosier Healthwise (HHW) programs were designed to be a whole family solution for qualifying Indiana f a m i l i e s . Fo r f a m i l i e s w h e re t h e children are eligible for HHW, the adults may be eligible for HIP 2.0. A l l e l i g i b i l i t y d e t e r m i n a t i o n s w i l l b e m a d e b y t h e Fa m i l y & S o c i a l S e r v i c e s A d m i n i s t r a t i o n (FSSA), and enrollment will be handled by Maximus. Healthy Indiana Plan, HIP 2.0 D e l a y s i n s u b m i t t i n g t h i s i n f o r m a t i o n t o H P P r o v i d e r Enrollment may result in erroneous payments or denials. P r o v i d e r s t h a t h a v e W e b Interchange access are able to make updates to the following information: Pay To and Mail To addresses; EFT information; additional specialties; a n d o r g a n i z a t i o n a l s t r u c t u r e information, as long as it is not a change of ownership. If a provider's Pay To address is not updated and results in a check being mailed to the wrong address, HP will not send a replacement check to the provider until the Pay To address is updated in IndianaAIM." For additional information see the IHCP Provider Manual, Chapter 4, Section 5, pages 53-58 (provider. i n d i a n a m e d i c a i d . c o m / i h c p / manuals/cover.pdf). W h e n a p r o v i d e r ' s a d d r e s s changes, any office that has access to WebInterchange can update their address and other information needed for accurate and timely Medicaid claims payment. Once the corrected address is documented in Web Interchange, CMCS will be able to update the claims processing s y s t e m a n d s e n d c h e c k s a n d remittance advice to the new accurate provider location. E n r o l l i n g i n E l e c t r o n i c Fu n d Tra n s f e r s ( E F T ) c o n t i n u e s t o b e t h e q u i c k e s t w a y t o re c e i v e re i m b u r s e m e n t f o r s e r v i c e s . If a provider requests paper checks, CMCS will comply with the above IHCP requirements. Any questions or assistance needed can be provided by your Medicaid delivery system provider relations representative, or by contacting Rochelle Bailey at (317) 575-7515 who will direct you to your representative. C O V E R A G E E X PA N S I O N I N I N D I A NA 0-23% FPL* 24-137% FPL 138-400% FPL Current Indiana Medicaid HIP Medicaid Expansion Health Insurance Marketplace C O N TA C T C M C S 9045 N. River Road, Suite 250 I n d i a n a p o l i s , I N 4 6 2 4 0 P h o n e : 3 1 7 . 5 7 8 . 4 3 0 0 To l l Fr e e : 8 8 8 . 5 0 4 . 5 5 5 6 Fa x : 8 0 0 . 74 7 . 3 6 9 3 (continued from page 5) 6 *FPL - Federal Poverty Level

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