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

Approved Application(s) and Related Documents

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

Administrative Record

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