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Healthy Indiana Plan

State: Indiana
Waiver Authority:
1115
Status: Pending

Waiver Dates

Approval: 01/27/2015
Effective: 02/01/2015
Expiration: 12/31/2020

Supporting Documents

Pending Application(s) and Related Documents

Date Title
Date 01/31/2020 Title Pending Application - State Extension Request (PDF, 12.21 MB) View/Submit Comments

Approved Application(s) and Related Documents

Date Title
Date 03/20/2020 Title Demonstration Approval (PDF, 3.52 MB)
Date 03/01/2018 Title Fact Sheet (PDF, 35.27 KB)

Administrative Record

Date Title
Date 04/01/2020 Title State Annual Report January – December 2019 (PDF, 1.06 MB)
Date 02/12/2020 Title CMS Completeness Letter – 2020 Extension Request (PDF, 986.58 KB)
Date 01/17/2020 Title State Acceptance Letter of HIP SMI Amendment (PDF, 1.74 MB)
Date 12/20/2019 Title Technical Corrections Demonstration Approval (PDF, 3.45 MB)
Date 12/09/2019 Title HIP SUD Quarterly Report July – September 2019 (PDF, 435.64 KB)
Date 12/09/2019 Title Quarterly Budget Neutrality Report July – September 2019 (XLSX, 69.33 KB)
Date 11/26/2019 Title HIP Quarterly Report July – September 2019 (ZIP, 975.82 KB)
Date 09/13/2019 Title CMS Completeness Letter – SMI/SED Amendment (PDF, 953.78 KB)
Date 08/30/2019 Title HIP Quarterly Report April – June 2019 (PDF, 363.88 KB)
Date 08/30/2019 Title HIP SUD DY 4 Annual Report (ZIP, 5.29 MB)
Date 08/30/2019 Title HIP SUD Quarterly Report April – June 2019 (ZIP, 2.11 MB)
Date 08/30/2019 Title SMI/SED Amendment Application (PDF, 4.39 MB) View Comments
Date 08/08/2019 Title CMS Completeness Letter - Workforce Bridge Account Amendment (PDF, 954.45 KB)
Date 06/06/2019 Title HIP SUD Evaluation Design (PDF, 1.51 MB)
Date 05/31/2019 Title HIP Quarterly Report January–March 2019 (PDF, 760.81 KB)
Date 04/11/2019 Title HIP DY 4 Annual Report (PDF, 924.71 KB)
Date 03/01/2019 Title CMS Draft Evaluation Design Feedback (PDF, 325.46 KB)
Date 11/30/2018 Title SUD Quarterly Report July – September 2018 (PDF, 762.39 KB)
Date 11/27/2018 Title HIP Draft Evaluation Design (PDF, 538.14 KB)
Date 11/27/2018 Title HIP Quarterly Report July – September 2018 (PDF, 822.46 KB)
Date 08/31/2018 Title HIP Quarterly Report April-June 2018 (PDF, 583.58 KB)
Date 08/31/2018 Title SUD Quarterly Report April-June 2018 (PDF, 483.3 KB)
Date 06/06/2018 Title Substance Use Disorder Health Information Technology Plan Approval (PDF, 501.04 KB)
Date 05/31/2018 Title HIP Quarterly Report February–March 2018 (PDF, 581.82 KB)
Date 05/31/2018 Title SUD Quarterly Report February–March 2018 (PDF, 465.51 KB)
Date 04/30/2018 Title HIP 2.0 Year 3 Annual Report (February 2017-January 2018) (PDF, 566.01 KB)
Date 03/31/2018 Title IN Quarterly Report November-December 2017 (PDF, 307.82 KB)
Date 02/28/2018 Title HIP Approval State Acceptance Letter (PDF, 541.93 KB)
Date 02/01/2018 Title CMS Amendment Approval (PDF, 2.09 MB)
Date 02/01/2018 Title SUD Implementation Protocol Approval (PDF, 624.1 KB)
Date 01/22/2018 Title CMS Temporary Extension Letter (PDF, 90.54 KB)
Date 01/22/2018 Title IN January 2018 Metrics Report (PDF, 81.39 KB)
Date 12/31/2017 Title IN Quarterly Report – August-October 2017 (PDF, 374.85 KB)
Date 12/19/2017 Title IN December 2017 Metrics Report (PDF, 79.53 KB)
Date 12/01/2017 Title Response from CMS on POWER Account Tiers (12/01/2017) (PDF, 111.13 KB)
Date 11/29/2017 Title Letter from the State on POWER Account Tiers (11/29/2017) (PDF, 86.6 KB)
Date 11/19/2017 Title IN November 2017 Metrics Report (PDF, 79.45 KB)
Date 10/19/2017 Title IN October 2017 Metrics Report (PDF, 76.78 KB)
Date 10/04/2017 Title IN 2016 Emergency Room Co-Payment Assessment Report (PDF, 1.67 MB)
Date 10/01/2017 Title IN Quarterly Report – May-July 2017 (PDF, 442.17 KB)
Date 09/25/2017 Title IN Provider Payment Report (PDF, 626.93 KB)
Date 09/19/2017 Title IN September 2017 Metrics Report (PDF, 81.25 KB)
Date 08/21/2017 Title IN August 2017 Metrics Report (PDF, 79.43 KB)
Date 07/20/2017 Title Demonstration Application – Amendment (PDF, 2.32 MB) View Comments
Date 07/19/2017 Title IN July 2017 Metrics Report (PDF, 79.44 KB)
Date 06/30/2017 Title IN Quarterly Report – February-April 2017 (PDF, 306.44 KB)
Date 06/19/2017 Title IN June 2017 Metrics Report (PDF, 79.64 KB)
Date 06/09/2017 Title CMS Completeness Letter (6/9/2017) (PDF, 110.51 KB)
Date 05/21/2017 Title IN May 2017 Metrics Report (PDF, 79.73 KB)
Date 04/30/2017 Title IN April 2017 Metrics Report (PDF, 79.62 KB)
Date 03/31/2017 Title POWER Account Contribution Assessment (3/31/2017) (PDF, 1.77 MB)
Date 03/31/2017 Title Quarterly Report November 2016 – January 2017 (3/31/2017) (PDF, 122.28 KB)
Date 03/28/2017 Title IN March 2017 Metrics Report (PDF, 79.63 KB)
Date 02/15/2017 Title Demonstration Application (PDF, 5.34 MB) View Comments
Date 02/03/2017 Title CMS Completeness Determination (2/3/17) (PDF, 102.71 KB)
Date 02/02/2017 Title HIP 2.0 Monthly Report: October 2016 (PDF, 79.54 KB)
Date 12/30/2016 Title Quarterly Report August 2016 - October 2016 (12/30/2016) (PDF, 381.72 KB)
Date 11/25/2016 Title CMS Approval - Indiana NEMT Temporary Extension (11/25/2016) (PDF, 128.36 KB)
Date 11/02/2016 Title HIP 2.0 NEMT Final Evaluation (11/02/2016) (PDF, 1.47 MB)
Date 09/30/2016 Title Quarterly Report May 2016 - July 2016 (09/30/2016) (PDF, 391.32 KB)
Date 09/16/2016 Title IN HIP 2.0 Emergency Room Copay 1916(f) Extension Letter (09/16/2016) (PDF, 65.9 KB)
Date 08/12/2016 Title Completeness Letter (08/12/2016) (PDF, 65.59 KB)
Date 08/12/2016 Title Indiana NEMT Extension Request (08/12/2016) (PDF, 1.85 MB) View Comments
Date 07/29/2016 Title CMS Letter to Indiana on Lockouts and Prior Claims Payment (7/29/2016) (PDF, 86.47 KB)
Date 07/20/2016 Title HIP 2.0 Monthly Report: July 2016 (07/20/2016) (PDF, 79.71 KB)
Date 07/06/2016 Title HIP 2.0 Monthly Report: June 2016 (07/06/2016) (PDF, 81.57 KB)
Date 07/06/2016 Title Interim Evaluation Report (07/6/2016) (PDF, 4.48 MB)
Date 06/30/2016 Title Quarterly Report: Feb 2016- Apr 2016 (06/30/2016) (PDF, 534.17 KB)
Date 06/10/2016 Title CMS letter to Indiana on Federal Evaluation DUA (06/10/2016) (PDF, 111.47 KB)
Date 06/01/2016 Title HIP 2.0 Monthly Report: May 2016 (06/01/2016) (PDF, 75.05 KB)
Date 04/29/2016 Title HIP 2.0 Year 1 Annual Report (February 2015-January 2016) (PDF, 1.06 MB)
Date 04/28/2016 Title Indiana Letter to CMS on Lockouts and Prior Claims Payment (4/28/2016) (PDF, 1.91 MB)
Date 04/20/2016 Title HIP 2.0 Monthly Report: April 2016 (PDF, 75.11 KB)
Date 03/31/2016 Title Quarter Report - Nov 2015 - Jan 2016 (03/31/2016) (PDF, 458.77 KB)
Date 03/21/2016 Title HIP 2.0 Monthly Report: March 2016 (03/21/2016) (PDF, 77.94 KB)
Date 03/11/2016 Title NEMT Evaluation - Updated 3/11/16 (PDF, 1.65 MB)
Date 02/26/2016 Title Indiana HIP 2.0: Evaluation of Non-Emergency Medical Transportation Waiver (02/26/2016) (PDF, 1.89 MB)
Date 02/22/2016 Title HIP 2.0 Monthly Report: February 2016 (02/22/2016) (PDF, 78.55 KB)
Date 02/04/2016 Title CMS Approved Emergency Department Copayment Protocol (02/04/2016) (PDF, 166.88 KB)
Date 01/19/2016 Title HIP 2.0 Monthly Report: January 2016 (01/19/2016) (PDF, 77.86 KB)
Date 12/29/2015 Title HIP 2.0 Provider Payment Report (12/29/2015) (PDF, 473 KB)
Date 12/29/2015 Title HIP 2.0 Quarterly Report - Demo Year 1 Qtr 3 (12/29/2015) (PDF, 162.64 KB)
Date 12/28/2015 Title Indiana HIP 2.0: Final Evaluation Design (12/28/2015) (PDF, 2.68 MB)
Date 12/22/2015 Title HIP 2.0 Monthly Report: December 2015 (12/22/2015) (PDF, 77.83 KB)
Date 12/22/2015 Title HIP 2.0 Response Letter (12/22/2015) (PDF, 72.73 KB)
Date 11/30/2015 Title Presumptive Eligibility Standards Proposal (11/30/2015) (PDF, 116.11 KB)
Date 11/24/2015 Title HIP 2.0 Monthly Report: November 2015 (11/24/2015) (PDF, 77.83 KB)
Date 11/05/2015 Title HIP 2.0 Evaluation Letter (11/05/2015) (PDF, 790.12 KB)
Date 10/29/2015 Title HIP 2.0 Draft Evaluation Design (10/29/2015) (PDF, 1.01 MB)
Date 10/27/2015 Title HIP Prior Claims Payment Report (10/27/2015) (PDF, 571.3 KB)
Date 10/23/2015 Title HIP 2.0 Monthly Report: October 2015 (10/23/2015) (PDF, 77.82 KB)
Date 10/22/2015 Title HIP 2.0 Link Protocol - Approved (10/22/2015) (PDF, 370.57 KB)
Date 10/08/2015 Title HIP 2.0 Quarterly Report - Demo Year 1 Qtr 2 (10/08/2015) (PDF, 219.97 KB)
Date 09/21/2015 Title HIP 2.0 Monthly Report: September 2015 (09/21/2015) (PDF, 73.78 KB)
Date 08/31/2015 Title HIP Passive Verification Report (08/31/2015) (PDF, 169.52 KB)
Date 08/31/2015 Title HIP Presumptive Eligibility Standards Report (08/31/2015) (PDF, 120.56 KB)
Date 08/12/2015 Title CMS Approval - POWER Account OP (08/12/2015) (PDF, 91.58 KB)
Date 08/05/2015 Title HIP 2.0 Quarterly Report - Demo Year 1 Qtr 1 (08/05/2015) (PDF, 215.16 KB)
Date 06/01/2015 Title Draft State Evaluation Design (06/01/2015) (PDF, 946.19 KB)
Date 05/26/2015 Title HIP Link Draft Protocol (PDF, 1.64 MB)
Date 05/14/2015 Title Technical Corrections Demonstration Approval (PDF, 545 KB)
Date 05/01/2015 Title Emergency Room Copay Protocol (PDF, 315.06 KB)
Date 02/26/2015 Title POWER Account and Copay Protocol (02/26/2015) (PDF, 536.44 KB)
Date 01/30/2015 Title Approval Letter (01/30/2015) (PDF, 98.98 KB)
Date 01/27/2015 Title HIP 2.0 Fact Sheet (PDF, 29.06 KB)
Date 01/27/2015 Title HIP Approval (PDF, 372.24 KB)
Date 08/22/2014 Title CMS Completeness Letter (PDF, 74.94 KB)
Date 08/21/2014 Title Report to CMS Indiana Tribal Consultation (PDF, 137.35 KB)
Date 07/02/2014 Title Healthy Indiana Plan Demonstration Application to Expand (PDF, 1.56 MB)
Date 06/23/2014 Title Healthy Indiana Plan Expansion Proposal (PDF, 108.86 KB)
Date 03/26/2013 Title Benchmark Equivalent Coverage Analysis (PDF, 2.47 MB)
Date Title Anthem Blue Cross and Blue Shield (PDF, 300.15 KB)
Date Title Health Benefit Booklet (PDF, 901.12 KB)
Date Title Healthy Indiana Plan Member Handbook (PDF, 2.09 MB)
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