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Indiana End Stage Renal Disease (ESRD) (formerly known as Healthy Indiana Plan 1.0)

State: Indiana
Waiver Authority:
1115
Status: Pending

Waiver Dates

Approval: 12/14/2007
Effective: 01/01/2008
Expiration: 12/31/2024

Supporting Documents

Pending Application(s) and Related Documents

Date Title
06/26/2020 Pending Application - Indiana ESRD Waiver Renewal (PDF, 3.33 MB) View/Submit Comments

Approved Application(s) and Related Documents

Date Title
11/28/2022 CMS Temporary Extension Approval (PDF, 314.72 KB)
12/17/2021 Demonstration Approval (PDF, 414.74 KB)
07/28/2016 Fact Sheet (PDF, 21.34 KB)

Administrative Record

Date Title
05/24/2024 State Quarterly Report – January to March 2024 (PDF, 280.61 KB)
03/30/2024 Annual Report October - December 2023 (PDF, 279.03 KB)
11/29/2023 State Quarterly Report – July - September 2023 (PDF, 275.56 KB)
08/29/2023 Quarterly Report April 2023 - June 2023 (PDF, 278.42 KB)
06/23/2023 CMS Temporary Extension Approval (PDF, 319.72 KB)
05/30/2023 Quarterly Report January – March 2023 (PDF, 273.2 KB)
05/30/2023 Quarterly Report January – March 2023 (PDF, 273.2 KB)
11/28/2022 Quarterly Report July-September 2022 (PDF, 275.89 KB)
06/06/2022 Quarterly Report January-March 2022 (PDF, 172.71 KB)
03/30/2022 Annual Report 2021 (PDF, 172.99 KB)
03/30/2022 Annual Report 2022 (PDF, 276.99 KB)
01/07/2022 State Acceptance Letter (PDF, 158.08 KB)
11/29/2021 Budget Neutrality Workbook July-September 2021 (XLSM, 433.44 KB)
11/29/2021 Quarterly Report July-September 2021 (PDF, 192.59 KB)
08/29/2021 Quarterly Report April-June 2021 (PDF, 270.19 KB)
08/27/2021 Budget Neutrality Workbook April-June 2021 (XLSM, 433.46 KB)
07/21/2021 Budget Neutrality Workbook January-March 2021 (XLSM, 433.41 KB)
06/30/2021 Quarterly Report January-March 2021 (PDF, 329.92 KB)
03/31/2021 Budget Neutrality Workbook October-December 2020 (XLSM, 429.36 KB)
02/12/2021 CMS Letter to State (PDF, 39.46 KB)
12/21/2020 CMS Temporary Extension Approval (PDF, 105.89 KB)
11/30/2020 Budget Neutrality Workbook July-September 2020 (XLSM, 426.5 KB)
11/30/2020 Quarterly Report July-September 2020 (PDF, 193.59 KB)
08/31/2020 Budget Neutrality Workbook April-June 2020 (XLSM, 425.74 KB)
08/31/2020 Quarterly Report April-June 2020 (PDF, 325.2 KB)
07/20/2020 CMS Technical Corrections (PDF, 244.85 KB)
07/08/2020 CMS Completeness Letter (PDF, 138.35 KB)
06/26/2020 Demonstration Acceptance Letter from the State (PDF, 309.97 KB)
06/03/2020 Budget Neutrality Workbook January-March 2020 (XLSM, 425.62 KB)
06/03/2020 Budget Neutrality Workbook July-September 2019 (XLSM, 431.92 KB)
05/29/2020 CMS Approval - Workforce Bridge Account Amendment (PDF, 562.34 KB)
05/29/2020 Quarterly Report January–March 2020 (PDF, 330.56 KB)
05/07/2020 Annual Report 2019 (PDF, 357.63 KB)
05/07/2020 Draft Annual Report 2020 (PDF, 280.16 KB)
03/31/2020 Quarterly Report October-December 2019 (PDF, 295.87 KB)
02/27/2020 Budget Neutrality Workbook October-December 2019 (XLSM, 425.68 KB)
11/21/2019 Quarterly Report July–September 2019 (PDF, 292.6 KB)
08/28/2019 Quarterly Report April–June 2019 (PDF, 292.27 KB)
07/25/2019 Workforce Bridge Account Amendment (PDF, 252.5 KB) View Comments
05/31/2019 Quarterly Report January–March 2019 (PDF, 291.07 KB)
04/30/2019 Annual Report 2018 (PDF, 307.88 KB)
02/27/2019 Quarterly Report October–December 2019 (PDF, 299.37 KB)
08/15/2018 Annual Report 2017 (PDF, 173.7 KB)
07/10/2018 Quarterly Report July–September 2017 (PDF, 225.2 KB)
06/29/2018 Quarterly Report January–March 2018 (PDF, 138.2 KB)
02/04/2018 Quarterly Report January–March 2017 (PDF, 224.55 KB)
03/22/2017 Final ESRD Evaluation Design (PDF, 112.28 KB)
03/02/2017 Quarterly Report October–December 2016 (PDF, 225.34 KB)
02/04/2017 Quarterly Report April–June 2017 (PDF, 223.79 KB)
12/05/2016 Quarterly Report July–September 2016 (PDF, 247.95 KB)
12/02/2016 ESRD Draft Evaluation Design (12/2/2016) (PDF, 252.88 KB)
08/31/2016 Quarterly Report April-June 2016 (PDF, 224.77 KB)
08/16/2016 State Extension Acceptance Letter (08/16/2016) (PDF, 904.05 KB)
07/28/2016 Demonstration Approval (PDF, 201.87 KB)
06/28/2016 CMS Temporary Extension (06/28/2016) (PDF, 100.72 KB)
05/25/2016 CMS Temporary Extension (05/25/2016) (PDF, 100.98 KB)
04/28/2016 CMS Temporary Extension (04/28/2016) (PDF, 101.19 KB)
03/30/2016 CMS Temporary Extension (03/30/2016) (PDF, 101.59 KB)
02/29/2016 CMS Temporary Extension (02/29/2016) (PDF, 101.81 KB)
01/29/2016 CMS Temporary Extension (01/29/2016) (PDF, 101.66 KB)
12/14/2015 CMS Temporary Extension (12/14/2015) (PDF, 101.82 KB)
07/20/2015 2015 Extension Application (07/20/2015) (PDF, 1.06 MB) View Comments
07/09/2015 CMS Completeness Letter (07/09/2015) (PDF, 99.25 KB)
12/31/2014 Enrollment Freeze Extension (12/31/2014) (PDF, 389.5 KB)
12/31/2014 Enrollment Freeze Extension Approval Letter (12/31/2014) (PDF, 86.17 KB)
12/12/2014 Quarterly Report July-September 2014 (PDF, 251.51 KB)
12/05/2014 Financial Monitoring Report July-September 2014 (PDF, 82.1 KB)
11/25/2014 Letter of Extension Approval (11/25/14) (PDF, 1.1 MB)
11/14/2014 CMS Temporary Extension (11/14/2014) (PDF, 98.34 KB)
10/31/2014 CMS Approval – Extending Temporary Enrollment Freeze (10/31/2014) (PDF, 85.26 KB)
10/21/2014 Letter of Extension Approval (10/21/2014) (PDF, 75.04 KB)
10/21/2014 Pending Application - 2014 Extension Application (PDF, 2.3 MB) View Comments
09/09/2014 Quarterly Report April-June 2014 (PDF, 283.09 KB)
09/05/2014 Financial Monitoring Report April-June 2014 (PDF, 82.1 KB)
08/21/2014 State Acceptance Letter (PDF, 1.08 MB)
07/23/2014 Amendment Approval Letter (07/23/2014) (PDF, 93.91 KB)
07/15/2014 Request for Extension of 1115 Demo Letter (07/15/14) (PDF, 76.61 KB)
06/27/2014 State Acceptance Letter (PDF, 1.22 MB)
05/30/2014 CMS Temporary Extension (05/30/2014) (PDF, 174.93 KB)
05/15/2014 Quarterly Report January-March 2014 (PDF, 280.21 KB)
05/09/2014 Financial Monitoring Report January-March 2014 (PDF, 280.21 KB)
02/28/2014 Financial Monitoring Report October-December 2013 (PDF, 1.05 MB)
02/28/2014 Quarterly Report October-December 2013 (PDF, 621.43 KB)
02/28/2014 State Quarterly Report October-December 2013 (PDF, 1.96 MB)
11/30/2013 Quarterly Report July - September 2013 (PDF, 677.17 KB)
11/22/2013 Financial Monitoring Report July-September 2013 (PDF, 90.79 KB)
09/03/2013 CMS Temporary Extension (09/03/2013) (PDF, 71.97 KB)
08/31/2013 Quarterly Report April-June 2013 (PDF, 270.75 KB)
08/31/2013 State Quarterly Report April-June 2013 (PDF, 190.14 KB)
05/31/2013 Quarterly Report January-March 2013 (PDF, 517.73 KB)
05/17/2013 Financial Monitoring Report January-March 2013 (PDF, 82.12 KB)
04/30/2013 Approval for Extension Letter (04/30/13) (PDF, 114.2 KB)
04/12/2013 Healthy Indiana 1115 Waiver Extension App (Submitted 04/12/13) (PDF, 1.19 MB)
04/11/2013 Letter of Update and Supplementation (04/11/13) (PDF, 144.89 KB)
03/26/2013 Benchmark Equivalent Coverage Analysis Healthy Indiana Plan Demo (03/26/13) (PDF, 816.29 KB)
03/08/2013 IHCP Bulletin (03/08/13) (PDF, 1.08 MB)
02/25/2013 Denial for Extension Letter (02/25/13) (PDF, 156.95 KB)
02/13/2013 Request for Extension of 1115 Demo Letter (02/13/13) (PDF, 389.17 KB)
01/30/2013 Summary Budget Neutrality Estimate - Waiver Renewal (01/30/13) (PDF, 962.33 KB)
01/16/2013 Special Terms and Conditions (01/16/13-12/31/13) (PDF, 837.91 KB)
01/16/2013 Waiver List (01/16/13-12/31/13) (PDF, 352.45 KB)
01/15/2013 Approval Letter to Extend Section 1115 (01/15/13) (PDF, 122.58 KB)
07/31/2012 Letter of Extension Approval (07/31/12) (PDF, 114.06 KB)
12/28/2011 Healthy Indiana 1115 Waiver Extension App (Submitted 12/28/11) (PDF, 500.06 KB)
12/27/2011 Letter Regarding Waiver Renewal Submission (12/27/11) (PDF, 127.09 KB)
11/30/2011 Letters of Support for Renewal of 1115 Medicaid Waiver (November 2011) (PDF, 1.85 MB)
09/10/2010 Letter Regarding Covering New Eligibles under HIP (09/10/10) (PDF, 134.77 KB)
12/22/2009 HIP 1.0 Final Evaluation Design 2008-2012 (12/22/2009) (PDF, 706.65 KB)
01/01/2008 Expenditure Authority (01/01/08-12/31/12 Amended January 2010) (PDF, 331.73 KB)
01/01/2008 Special Terms and Conditions (01/01/08-12/31/12 Amended January 2010) (PDF, 938.5 KB)
Advantage Health Solutions Inc. (PDF, 938.65 KB)
Anthem Blue Cross and Blue Shield Healthy Indiana Plan (PDF, 371.93 KB)
Approval for Amendment Letter (PDF, 68.18 KB)
BCBS Service Benefit Plan 2009 (PDF, 1.29 MB)
Expenditure Authority (PDF, 536.81 KB)
Health Benefit Booklet Blue Access PPO Anthem Traditional Plan II ASO 2009 (PDF, 507.75 KB)
Letter Regarding 1115 Waiver Renewal - Budget Neutrality (PDF, 129.62 KB)
Mdwise Healthy Indiana Plan Member Handbook (PDF, 2 MB)
Public Comments (PDF, 107.64 KB)
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