🚨 Speak Up Now: Make Your Voice Heard — Public Feedback Is Needed 🚨
Indiana Medicaid offers several Home and Community-Based Services (HCBS) waivers that allow individuals with disabilities or long-term needs to receive care in their homes or community instead of an institutional setting. Each waiver has its own eligibility criteria, covered services, and program guidelines.
You can access the official manuals below to better understand what each waiver covers, how services are approved, and what responsibilities providers and families have.
🔍 Waiver Programs Covered:
Pathways for Aging Waiver (PathWays) – for individuals aged 60 and older who are aged, blind, or disabled and need a nursing facility level of care
Health & Wellness Waiver (H&W Waiver) – for individuals aged 59 and younger who are aged, blind, or disabled and need a nursing facility level of care
Traumatic Brain Injury (TBI) Waiver – for individuals with a documented traumatic brain injury
Community Integration & Habilitation (CIH) Waiver – for individuals with intellectual or developmental disabilities requiring high levels of support
Family Supports Waiver (FSW) – for individuals with intellectual or developmental disabilities who need ongoing services but not 24/7 care
🔗 Access Waiver Manuals:
The IHCP Medical Policy Manual includes a detailed section on Home Health Services for individuals covered by Indiana Medicaid.
This section explains:
✔️ Who qualifies for home health services (must be medically confined to home)
✔️ What services are covered, including skilled nursing, therapy, and aide support
✔️ When prior authorization (PA) is required and when it’s not
✔️ Documentation needed for PA requests
✔️ How many hours may be approved, depending on care needs and family situation
✔️ Which services are not covered (like homemaker or companion care)
✔️ Special billing rules, such as limits on overhead charges and multiple visits
✔️ Clinical indicators for specific conditions like CNS disorders or gastrointestinal issues
This manual is primarily for providers and agencies, but it’s helpful for families to understand the eligibility rules, care standards, and how decisions are made about service approvals.
📄 Link to Manual:
IHCP Medical Policy Manual – Home Health Services Section (starts on page 197)
Your voice matters—whether you're advocating for change or staying informed. Follow us on Facebook for timely updates, or explore how to participate in Medicaid policy through public comments and policy requests. Together, we can help shape a better system for Indiana families.
ASD – Autism Spectrum Disorder
APS – Adult Protective Services
ANE – Abuse, Neglect, and Exploitation
A&D Waiver – Aged and Disabled Waiver
ADA – Americans with Disabilities Act
ADLs – Activities of Daily Living
ABA – Applied Behavior Analysis Therapy
ATTC – Attendant Care Services
BDS – Bureau of Disabilities Services
BDDS – Bureau of Developmental Disabilities Services
BMAN – Behavior Management Services
CARF – Commission on Accreditation of Rehabilitation Facilities
CASA – Court Appointed Special Advocate
CM – Case Manager
CCC – Case Conference Committee
CSHCS – Children's Special Health Care Services
CIH – Community Integration and Habilitation Waiver
CMS – Centers for Medicare & Medicaid Services
CRF/DD – Community Residential Facility for the Developmentally Disabled
CMO – Case Management Organization
CPS – Child Protective Services
DA – Division of Aging
DCS – Department of Child Services
DD – Developmental Disability
DDRS – Division of Disability and Rehabilitative Services
DFR – Division of Family Resources
DMHA – Division of Mental Health and Addiction
DSP – Direct Support Professional
DME – Durable Medical Equipment
EPSDT – Early Periodic Screening, Diagnosis, and Treatment
EVV – Electronic Visit Verification
FAPE – Free and Appropriate Public Education
FPL – Federal Poverty Level
FSW – Family Supports Waiver
HAB – Habilitation
HCBS – Home- and Community-Based Services
H&W Waiver – Health & Wellness Waiver
HHA – Home Health Agency / Home Health Aide
HIPAA – Health Insurance Portability and Accountability Act
HRC – Human Rights Committee
HHW – Hoosier Healthwise
IADLs – Instrumental Activities of Daily Living
IR – Incident Report
IRT – InterRAI Tool
IAC – Indiana Administrative Code
IC – Indiana Code / Informed Choice
ID – Intellectual Disability
IDD – Intellectual and Developmental Disabilities
IDEA – Individuals with Disabilities Education Act
IDEIA – Individuals with Disabilities Education Improvement Act
IEP – Individualized Education Plan
IHCP – Indiana Health Coverage Programs
ISP – Individualized Service Plan
ILCs – Independent Living Centers
ISDH – Indiana State Department of Health
ICF/IID – Intermediate Care Facility for Individuals with Intellectual Disabilities
IST – Individualized Support Team
JCAHO – The Joint Commission on the Accreditation of Healthcare Organizations
LPI – Legacy Provider Identification
LCSW – Licensed Clinical Social Worker
LOC – Level-of-Care
MCE – Managed Care Entity
MFP – Money Follows the Person
NOA – Notice of Action
NPI – National Provider Identifier
OT – Occupational Therapist
OMPP – Office of Medicaid Policy and Planning
PAC – Participant Assistance and Care
PCP – Primary Care Physician
POC – Plan of Care
PCP – Primary Care Physician
PA – Prior Authorization
PAC – Participant Assistance and Care
PCA – Personal Care Assistants
PCISP – Person-Centered Individualized Support Plan
PT – Physical Therapy
RID – Recipient Identification Number
SSDI – Social Security Disability Insurance
SSI – Supplemental Security Income
SFC – Structured Family Caregiving
SGL – Supervised Group Living
TBI – Traumatic Brain Injury
WIC – Women, Infants, and Children Program