Indiana Spotlight: Upcoming Changes to Indiana Health Coverage Programs (IHCP)

Indiana Medicaid is a part of the Indiana Health Coverage Programs (IHCP), a number of programs that provide coverage for Hoosiers who are older adults, disabled, blind, pregnant, or otherwise eligible for coverage. This includes the Healthy Indiana Plan (HIP), Hoosier Care Connect, Hoosier Healthwise and Traditional Medicaid within Indiana. These programs cover over one million Hoosiers in Indiana through both fee-for-service and managed care.

There have been a number of recent and upcoming changes relating to IHCP that providers should make themselves aware of including expanded telehealth services as well as an upcoming end to continuous full coverage eligibility.

Expansion of Covered Telehealth Services

Coverage of audio-only telehealth via IHCPs, including through Indiana Medicaid, has been expanded as of December 9^th, 2022. This coverage includes patient evaluation and management for both new and existing patients when performed via audio-only telehealth. See the table for the procedure codes as well as a brief description of the services covered.

In order to be covered, these services must be billed with the audio-only modifier as well as the appropriate POS Code. At this point, these services are covered through the end of 2023. They are among the telehealth services that are being covered on a provisionary basis to determine whether or not they are useful for expanding access and ensuring coverage.

More information about expanded coverage can be found in this ICHP bulletin.

Upcoming Restrictions and Coverage Changes

Due to the federal public health emergency (PHE), those enrolled in all full coverage programs under IHCP have had continuous eligibility since March 31, 2020. This means that they did not lose coverage unless they voluntarily withdrew from the program or moved out of state. However, changes made via federal funding bills have uncoupled this provision from the extension of the federal public health emergency (PHE).

Effective on March 31, 2023 this provision will end and full coverage IHCP members will no longer have continuous eligibility. In order to maintain their coverage, they will once again be subject to the same standard member eligibility rules that were in place prior to March of 2020. At this time, the only coverage change being made is to the continuous eligibility that was allowed under the federal PHE. Other Medicaid exceptions applied during the PHE – including cost-sharing – will be addressed at a later time.

Though this issue does not strictly affect telehealth, providers should be aware of the potential that their patients will lose their Medicaid coverage. Resources are available from Indiana FSSA for those who may have questions or concerns about maintaining their coverage. More information about this change can be found here in this ICHP bulletin. Resources are available through Connecting Kids to Coverage (CKC) to reach families with information about the health insurance coverage.

These recent and upcoming changes to IHCP coverage will impact Hoosiers throughout the state. Increased audio only coverage for services via telehealth will allow for greater coverage through the end of 2023. But providers and health professionals should be aware of the upcoming coverage changes that will lead to a greater number of uninsured patients within Indiana. As we move away from ICHP coverage being tied to the PHE, more changes are expected to provisions that were allowed in response to the COVID-19 pandemic.

This post is intended to be informational, not to shape policy or coverage decisions. For more information, contact Indiana FSSA.

Further Resources:

• Indiana Medicaid for Providers – Indiana FSSA
• Changes to Medicaid in 2023 – American Hospital Association
• States and Continuous Coverage – Center of Budget and Policy Priority
• Connecting Kids to Coverage – Get Help