DDRS Waiver Manual

Section 3.1: Other Program Information
Information about the variety of healthcare programs offered through the Indiana Health
Coverage Programs (IHCP), including Hoosier Healthwise, Hoosier Care Connect, the Healthy
Indiana Plan (HIP), and Traditional Medicaid (Fee-for-Service), is available on About Indiana
Medicaid at indianamedicaid.com. See the Indiana Health Coverage Programs’ Provider Reference
Module titled Member Eligibility and Benefit Coverage for detailed information about member
eligibility and services.
Individuals enrolled in Medicare, and those residing in an institution or receiving services through
a home and community-based services (HCBS) waiver, will not be eligible for managed care
programs such as Hoosier Care Connect.
If an individual is a Hoosier Healthwise or Medicaid managed care program participant, the Case
Manager must contact the local FSSA/DFR caseworker to coordinate the managed care program
stop date and waiver services start date.
DDRS’ BDDS Service Coordinators and DDRS-approved Case Managers and Providers of other
waiver-funded services may review the Indiana Health Coverage Programs’ Provider Reference
Module titled Member Eligibility and Benefit Coverage for detailed information about member
eligibility and services in order to assist applicants and waiver participants.
Section 3.2: Hospice Services
Individuals who receive Medicaid HCBS waiver services and elect to use the Indiana Health Care
Program Hospice benefit do not have to terminate their waiver program. However, the hospice
provider will coordinate the direct care for those services held in common by both programs, so
there is no duplication of services. In short, the individual receiving waiver services, who elects
the hospice benefit, may still receive waiver services that are not related to the terminal
condition and do not replicate hospice care. The hospice provider and the waiver case manager
must collaborate and communicate regularly to ensure the best possible overall care to the
individual waiver participant/hospice member. If applicable, the waiver case manager and
managed care benefit advocate must inform the individual and individual’s parent or guardian
of his or her options to ensure he or she makes an informed choice. Additional information is
available in the Indiana Health Coverage Programs’ Provider Reference Modules, under the
Service- and Provider-Specific Module titled Hospice Services.
Section 3.3: Medicaid Prior Authorization and Funding Streams
CMS requires that a HCBS waiver participant exhaust all services on the State Plan before utilizing
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