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Healthy Indiana Plan

State: Indiana
Waiver Authority:
1115
Status: Approved

Waiver Dates

Approval: 01/27/2015
Effective: 02/01/2015
Expiration: 12/31/2030

Supporting Documents

Approved Application(s) and Related Documents

Date Title
Date   03/02/2023 Title   Demonstration Approval (PDF, 5.18 MB)
Date   07/26/2022 Title   COVID-19 Amendment Approval (PDF, 285.98 KB)
Date   03/01/2018 Title   Fact Sheet (PDF, 35.27 KB)

Administrative Record

Date Title
Date   03/02/2023 Title   CMS Approved Eligibility and Coverage Monitoring Protocol (Part A) (XLSX, 209.18 KB)
Date   03/02/2023 Title   CMS Approved Eligibility and Coverage Monitoring Protocol (Part B) (PDF, 340.89 KB)
Date   08/02/2022 Title   State Acceptance Letter - COVID-19 Amendment (PDF, 185.68 KB)
Date   03/30/2022 Title   HIP DY 7 Annual Report 2021 (PDF, 423.95 KB)
Date   01/28/2022 Title   State Public Health Emergency Application (PDF, 348.95 KB)
Date   11/29/2021 Title   Budget Neutrality Workbook July-September 2021 (XLSM, 437.86 KB)
Date   11/29/2021 Title   Quarterly Report July-September 2021 (PDF, 388.05 KB)
Date   08/27/2021 Title   Budget Neutrality Workbook April-June 2021 (XLSM, 437.45 KB)
Date   08/27/2021 Title   Quarterly Report April-June 2021 (PDF, 424.71 KB)
Date   07/22/2021 Title   CMS Approved SMI Monitoring Protocol Part A (XLSX, 5.42 MB)
Date   07/22/2021 Title   CMS Approved SMI Monitoring Protocol Part B (PDF, 369.44 KB)
Date   07/22/2021 Title   CMS Approved SUD Monitoring Protocol Part A (XLSX, 193.52 KB)
Date   07/22/2021 Title   CMS Approved SUD Monitoring Protocol Part B (PDF, 340.71 KB)
Date   07/22/2021 Title   Demonstration Approval - CMS Approved SUD and SMI Monitoring Protocols (PDF, 2.79 MB)
Date   06/30/2021 Title   Budget Neutrality Workbook July- September 2020 (XLSM, 434.02 KB)
Date   06/30/2021 Title   Budget Neutrality Workbook October- December 2020 (XLSM, 433.15 KB)
Date   06/24/2021 Title   CMS Withdrawal - Community Engagement (, 171 B)
Date   05/30/2021 Title   Budget Neutrality Workbook January- March 2021 (XLSM, 437.52 KB)
Date   05/30/2021 Title   Quarterly Report January-March 2021 (DOCX, 155.62 KB)
Date   03/10/2021 Title   Letter from State (PDF, 153.22 KB)
Date   02/12/2021 Title   CMS Letter to State (PDF, 39.46 KB)
Date   02/12/2021 Title   CMS Letter to State about Demonstration (PDF, 313.33 KB)
Date   12/16/2020 Title   CMS Approval – SMI Evaluation Design (01/01/2020 – 12/31/2020) (PDF, 7.52 MB)
Date   12/16/2020 Title   CMS Approved SMI Evaluation Design (01/01/2020 – 12/31/2020) (PDF, 864.63 KB)
Date   12/09/2020 Title   CMS Approved SMI Monitoring Protocol Part A (01/01/2020 – 12/31/2020) (XLSM, 141.62 KB)
Date   12/09/2020 Title   CMS Approved SMI Monitoring Protocol Part B (01/01/2020 – 12/31/2020 (PDF, 431.38 KB)
Date   12/09/2020 Title   CMS SMI Monitoring Protocol Approval (PDF, 6.89 MB)
Date   11/30/2020 Title   CMS Approval – HIP Evaluation Design (02/01/2018 – 12/31/2020) (PDF, 7 MB)
Date   11/30/2020 Title   CMS Approved HIP Evaluation Design (02/01/2018 – 12/31/2020) (PDF, 2.74 MB)
Date   11/30/2020 Title   HIP Quarterly Report July-September 2020 (PDF, 391.81 KB)
Date   11/30/2020 Title   SUD Quarterly Report July - September 2020 (Part A) (XLSX, 620.77 KB)
Date   11/30/2020 Title   SUD Quarterly Report July - September 2020 (Part B) (PDF, 406.59 KB)
Date   11/30/2020 Title   SUD Retrospective Report October 2019 - June 2020 (Part A) (XLSX, 1.6 MB)
Date   11/30/2020 Title   SUD Retrospective Report October 2019 - June 2020 (Part B) (PDF, 230.07 KB)
Date   11/24/2020 Title   State Acceptance Letter- HIP Extension (PDF, 282.5 KB)
Date   10/26/2020 Title   CMS Approval - Extension Request (PDF, 9.32 MB)
Date   09/09/2020 Title   CMS Approval – SUD Monitoring Protocol (02/01/2018 – 12/31/2020) (PDF, 4.2 MB)
Date   09/09/2020 Title   CMS Approved Indiana HIP SUD Monitoring Protocol (Part A) (XLSX, 213.79 KB)
Date   09/09/2020 Title   CMS Approved Indiana HIP SUD Monitoring Protocol (Part B) (PDF, 227.64 KB)
Date   09/01/2020 Title   Budget Neutrality Workbook April-June 2020 (XLSM, 430.81 KB)
Date   08/26/2020 Title   HIP Quarterly Report April-June 2020 (PDF, 932.31 KB)
Date   07/09/2020 Title   Final SUD Interim Evaluation Report (02/01/2018 – 12/31/2020) (PDF, 4.38 MB)
Date   05/29/2020 Title   Budget Neutrality Workbook January-March 2020 (XLSM, 430.55 KB)
Date   05/29/2020 Title   Budget Neutrality Workbook October-December 2019 (XLSM, 430.76 KB)
Date   05/29/2020 Title   Final SUD Mid-Point Assessment Report (02/01/2018 – 12/31/2020) (PDF, 3.53 MB)
Date   05/29/2020 Title   State Quarterly Report January – March 2020 (PDF, 817.6 KB)
Date   04/01/2020 Title   State Annual Report January – December 2019 (PDF, 1.06 MB)
Date   03/20/2020 Title   CMS Technical Corrections – SMI/SED Amendment (PDF, 3.52 MB)
Date   02/12/2020 Title   CMS Completeness Letter – 2020 Extension Request (PDF, 986.58 KB)
Date   01/31/2020 Title   State Extension Application Request (PDF, 12.21 MB) View Comments
Date   01/17/2020 Title   State Acceptance Letter of HIP SMI Amendment (PDF, 1.74 MB)
Date   12/20/2019 Title   CMS SMI Amendment Approval (PDF, 3.45 MB)
Date   12/20/2019 Title   Draft SUD Interim Evaluation Report (02/01/2018 – 12/31/2020) (PDF, 3.42 MB)
Date   12/09/2019 Title   HIP SUD Quarterly Report July - September 2019 (ZIP, 482.58 KB)
Date   11/26/2019 Title   Budget Neutrality Workbook July-September 2019 (XLSM, 430.28 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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