Medicaid HCBS

Indiana Home- and Community-Based Services Waivers

This program allows Indiana Medicaid programs to pay for services that are provided in a person’s home or other community setting, rather than a Medicaid-funded facility or institution. Persons must qualify for institutional care in order to be eligible for home- and community-based services. Waiver refers to the waiving of certain federal requirements that otherwise apply to Medicaid program services.

Dear Indiana HCBS Provider,

On July 1, 2024, the Aged and Disabled Waiver split into two new waivers, the Health and Wellness Waiver for individuals 59 and under and the PathWays Waiver for individuals 60 and older. The Health and Wellness and Traumatic Brain Injury Waiver are administered by the Division of Disability and Rehabilitative Services. The PathWays Waiver is administered by the Office of Medicaid Policy and Planning.

Information about becoming a waiver service provider can be found here.  While these HCBS Waivers share many common statutory and regulatory requirements, it is important that you, as a prospective provider, review the few but important differences between the waivers to ensure your organization's capacity to effectively offer the service. Information about SFC on these waivers is available in a webinar created by the FSSA to ensure you are fully informed regarding each waiver. This webinar is available here.

For questions regarding the H&W or TBI Waiver, you may contact the Bureau of Disability Services at BDSProviderServices@fssa.in.gov. Information about the H&W Waivers, PathWays Waiver and the TBI Waiver can be found here.

Thank you for the many ways you improve the lives of Indiana's HCBS Waiver recipients. The FSSA looks forward to working with you as we expand options and opportunities for our fellow Hoosiers served by Indiana's HCBS Waivers.

Waivers

The following have been approved by CMS and will take effect July 1, 2024.

• H&W Waiver
• HCC Waiver
• PathWays 1915b Waiver
  • PathWays Waiver
• TBI Waiver

• IHCP bulletin (April 9, 2024)
• Pathways and Waiver Transition Public Comment
  • 11/21/23 Meeting: A&D to H&W, FSW & CIH Waiver Public Comment Webinar
  • 11/29/23 Meeting: Joint PathWays and Waiver Transition Public Comment Webinar
• Provider Compliance Reviews
  • PCR Webinar Slides
    • PCR Webinar Recording
  • FAQ
• Regulations:
  • The Aging Rule
  • HCBS waiver provider manual
• Past waivers:
  • Aged & Disabled Waiver, effective July 1, 2023
  • Aged & Disabled Waiver, effective February 1, 2020
    • Aged and Disabled waiver participant directed self-care amendment, effective July 1, 2020
  • Traumatic Brain Injury Waiver, effective July 1, 2023
  • Traumatic Brain Injury Waiver, effective January 1, 2023
  • Traumatic Brain Injury Waiver, effective February 1, 2020
• Waiver rates:
  • HCBS Waiver Rates Effective as of February 1, 2020  
  • 2022 allowable room and board rate
  • TBI Rate Amendment
  • A&D Rate Amendment

Aged and Disabled Waiver

The Aged & Disabled waiver provides an alternative to nursing facility admission for adults and persons of all ages with a disability. The waiver is designed to provide services to supplement informal supports for people who would require care in a nursing facility if waiver or other supports were not available. Waiver services can be used to help people remain in their own homes, as well as assist people living in nursing facilities to return to community settings such as their own homes, apartments, assisted living or Adult Family Care.