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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
03/21/2023 Demonstration Approval (PDF, 9.68 MB)
07/26/2022 COVID-19 Amendment Approval (PDF, 285.98 KB)
03/01/2018 Fact Sheet (PDF, 35.27 KB)

Administrative Record

Date Title
12/22/2023 CMS Letter to the State (PDF, 254.42 KB)
05/22/2023 CMS Approved HIP COVID-19 PHE Managed Care Rate Differential Evaluation Design (PDF, 278.23 KB)
03/21/2023 CMS Approved Eligibility and Coverage Evaluation Design (PDF, 1.7 MB)
03/21/2023 CMS Approved SMI/SED Evaluation Design (PDF, 2.34 MB)
03/21/2023 CMS Approved SUD Evaluation Design (PDF, 1.05 MB)
03/02/2023 CMS Approved Eligibility and Coverage Monitoring Protocol (Part A) (XLSX, 209.18 KB)
03/02/2023 CMS Approved Eligibility and Coverage Monitoring Protocol (Part B) (PDF, 340.89 KB)
03/02/2023 Demonstration Approval – CMS Approved Eligibility and Coverage Monitoring Protocol (PDF, 5.18 MB)
08/02/2022 State Acceptance Letter - COVID-19 Amendment (PDF, 185.68 KB)
06/30/2022 CMS Approved SUD Summative Evaluation Report (PDF, 8.57 MB)
06/15/2022 CMS Approved SMI Summative Evaluation Report (PDF, 3.2 MB)
03/30/2022 HIP DY 7 Annual Report 2021 (PDF, 423.95 KB)
01/28/2022 State Public Health Emergency Application (PDF, 348.95 KB)
11/29/2021 Budget Neutrality Workbook July-September 2021 (XLSM, 437.86 KB)
11/29/2021 Quarterly Report July-September 2021 (PDF, 388.05 KB)
08/27/2021 Budget Neutrality Workbook April-June 2021 (XLSM, 437.45 KB)
08/27/2021 Quarterly Report April-June 2021 (PDF, 424.71 KB)
07/22/2021 CMS Approved SMI Monitoring Protocol Part A (XLSX, 5.42 MB)
07/22/2021 CMS Approved SMI Monitoring Protocol Part B (PDF, 369.44 KB)
07/22/2021 CMS Approved SUD Monitoring Protocol Part A (XLSX, 193.52 KB)
07/22/2021 CMS Approved SUD Monitoring Protocol Part B (PDF, 340.71 KB)
07/22/2021 Demonstration Approval - CMS Approved SUD and SMI Monitoring Protocols (PDF, 2.79 MB)
06/30/2021 Budget Neutrality Workbook July- September 2020 (XLSM, 434.02 KB)
06/30/2021 Budget Neutrality Workbook October- December 2020 (XLSM, 433.15 KB)
06/24/2021 CMS Withdrawal - Community Engagement (PDF, 1.91 MB)
05/30/2021 Budget Neutrality Workbook January- March 2021 (XLSM, 437.52 KB)
05/30/2021 Quarterly Report January-March 2021 (DOCX, 155.62 KB)
03/10/2021 Letter from State (PDF, 153.22 KB)
02/12/2021 CMS Letter to State (PDF, 39.46 KB)
02/12/2021 CMS Letter to State about Demonstration (PDF, 313.33 KB)
12/16/2020 CMS Approval – SMI Evaluation Design (01/01/2020 – 12/31/2020) (PDF, 7.52 MB)
12/16/2020 CMS Approved SMI Evaluation Design (01/01/2020 – 12/31/2020) (PDF, 864.63 KB)
12/09/2020 CMS Approved SMI Monitoring Protocol Part A (01/01/2020 – 12/31/2020) (XLSM, 141.62 KB)
12/09/2020 CMS Approved SMI Monitoring Protocol Part B (01/01/2020 – 12/31/2020 (PDF, 431.38 KB)
12/09/2020 CMS SMI Monitoring Protocol Approval (PDF, 6.89 MB)
11/30/2020 CMS Approval – HIP Evaluation Design (02/01/2018 – 12/31/2020) (PDF, 7 MB)
11/30/2020 CMS Approved HIP Evaluation Design (02/01/2018 – 12/31/2020) (PDF, 2.74 MB)
11/30/2020 HIP Quarterly Report July-September 2020 (PDF, 391.81 KB)
11/30/2020 SUD Quarterly Report July - September 2020 (Part A) (XLSX, 620.77 KB)
11/30/2020 SUD Quarterly Report July - September 2020 (Part B) (PDF, 406.59 KB)
11/30/2020 SUD Retrospective Report October 2019 - June 2020 (Part A) (XLSX, 1.6 MB)
11/30/2020 SUD Retrospective Report October 2019 - June 2020 (Part B) (PDF, 230.07 KB)
11/24/2020 State Acceptance Letter- HIP Extension (PDF, 282.5 KB)
10/26/2020 CMS Approval - Extension Request (PDF, 9.32 MB)
09/09/2020 CMS Approval – SUD Monitoring Protocol (02/01/2018 – 12/31/2020) (PDF, 4.2 MB)
09/09/2020 CMS Approved Indiana HIP SUD Monitoring Protocol (Part A) (XLSX, 213.79 KB)
09/09/2020 CMS Approved Indiana HIP SUD Monitoring Protocol (Part B) (PDF, 227.64 KB)
09/01/2020 Budget Neutrality Workbook April-June 2020 (XLSM, 430.81 KB)
08/26/2020 HIP Quarterly Report April-June 2020 (PDF, 932.31 KB)
07/09/2020 Final SUD Interim Evaluation Report (02/01/2018 – 12/31/2020) (PDF, 4.38 MB)
05/29/2020 Budget Neutrality Workbook January-March 2020 (XLSM, 430.55 KB)
05/29/2020 Budget Neutrality Workbook October-December 2019 (XLSM, 430.76 KB)
05/29/2020 Final SUD Mid-Point Assessment Report (02/01/2018 – 12/31/2020) (PDF, 3.53 MB)
05/29/2020 State Quarterly Report January – March 2020 (PDF, 817.6 KB)
04/01/2020 State Annual Report January – December 2019 (PDF, 1.06 MB)
03/20/2020 CMS Technical Corrections – SMI/SED Amendment (PDF, 3.52 MB)
02/12/2020 CMS Completeness Letter – 2020 Extension Request (PDF, 986.58 KB)
01/31/2020 State Extension Application Request (PDF, 12.21 MB) View Comments
01/17/2020 State Acceptance Letter of HIP SMI Amendment (PDF, 1.74 MB)
12/20/2019 CMS SMI Amendment Approval (PDF, 3.45 MB)
12/20/2019 Draft SUD Interim Evaluation Report (02/01/2018 – 12/31/2020) (PDF, 3.42 MB)
12/09/2019 HIP SUD Quarterly Report July - September 2019 (ZIP, 482.58 KB)
11/26/2019 Budget Neutrality Workbook July-September 2019 (XLSM, 430.28 KB)
11/26/2019 HIP Quarterly Report July – September 2019 (ZIP, 975.82 KB)
09/13/2019 CMS Completeness Letter – SMI/SED Amendment (PDF, 953.78 KB)
08/30/2019 HIP Quarterly Report April – June 2019 (PDF, 363.88 KB)
08/30/2019 HIP SUD DY 4 Annual Report (ZIP, 5.29 MB)
08/30/2019 HIP SUD Quarterly Report April – June 2019 (ZIP, 2.11 MB)
08/30/2019 SMI/SED Amendment Application (PDF, 4.39 MB) View Comments
08/08/2019 CMS Completeness Letter - Workforce Bridge Account Amendment (PDF, 954.45 KB)
06/06/2019 HIP SUD Evaluation Design (PDF, 1.51 MB)
05/31/2019 HIP Quarterly Report January–March 2019 (PDF, 760.81 KB)
04/11/2019 HIP DY 4 Annual Report (PDF, 924.71 KB)
03/01/2019 CMS Draft Evaluation Design Feedback (PDF, 325.46 KB)
11/30/2018 SUD Quarterly Report July – September 2018 (PDF, 762.39 KB)
11/27/2018 HIP Draft Evaluation Design (PDF, 538.14 KB)
11/27/2018 HIP Quarterly Report July – September 2018 (PDF, 822.46 KB)
08/31/2018 HIP Quarterly Report April-June 2018 (PDF, 583.58 KB)
08/31/2018 SUD Quarterly Report April-June 2018 (PDF, 483.3 KB)
06/06/2018 Substance Use Disorder Health Information Technology Plan Approval (PDF, 501.04 KB)
05/31/2018 HIP Quarterly Report February–March 2018 (PDF, 581.82 KB)
05/31/2018 SUD Quarterly Report February–March 2018 (PDF, 465.51 KB)
04/30/2018 HIP 2.0 Year 3 Annual Report (February 2017-January 2018) (PDF, 566.01 KB)
03/31/2018 IN Quarterly Report November-December 2017 (PDF, 307.82 KB)
02/28/2018 HIP Approval State Acceptance Letter (PDF, 541.93 KB)
02/01/2018 CMS Amendment Approval (PDF, 2.09 MB)
02/01/2018 SUD Implementation Protocol Approval (PDF, 624.1 KB)
01/22/2018 CMS Temporary Extension Letter (PDF, 90.54 KB)
01/22/2018 IN January 2018 Metrics Report (PDF, 81.39 KB)
12/31/2017 IN Quarterly Report – August-October 2017 (PDF, 374.85 KB)
12/19/2017 IN December 2017 Metrics Report (PDF, 79.53 KB)
12/01/2017 Response from CMS on POWER Account Tiers (12/01/2017) (PDF, 111.13 KB)
11/29/2017 Letter from the State on POWER Account Tiers (11/29/2017) (PDF, 86.6 KB)
11/19/2017 IN November 2017 Metrics Report (PDF, 79.45 KB)
10/19/2017 IN October 2017 Metrics Report (PDF, 76.78 KB)
10/04/2017 IN 2016 Emergency Room Co-Payment Assessment Report (PDF, 1.67 MB)
10/01/2017 IN Quarterly Report – May-July 2017 (PDF, 442.17 KB)
09/25/2017 IN Provider Payment Report (PDF, 626.93 KB)
09/19/2017 IN September 2017 Metrics Report (PDF, 81.25 KB)
08/21/2017 IN August 2017 Metrics Report (PDF, 79.43 KB)
07/20/2017 Demonstration Application – Amendment (PDF, 2.32 MB) View Comments
07/19/2017 IN July 2017 Metrics Report (PDF, 79.44 KB)
06/30/2017 IN Quarterly Report – February-April 2017 (PDF, 306.44 KB)
06/19/2017 IN June 2017 Metrics Report (PDF, 79.64 KB)
06/09/2017 CMS Completeness Letter (6/9/2017) (PDF, 110.51 KB)
05/21/2017 IN May 2017 Metrics Report (PDF, 79.73 KB)
04/30/2017 IN April 2017 Metrics Report (PDF, 79.62 KB)
03/31/2017 POWER Account Contribution Assessment (3/31/2017) (PDF, 1.77 MB)
03/31/2017 Quarterly Report November 2016 – January 2017 (3/31/2017) (PDF, 122.28 KB)
03/28/2017 IN March 2017 Metrics Report (PDF, 79.63 KB)
02/15/2017 Demonstration Application (PDF, 5.34 MB) View Comments
02/03/2017 CMS Completeness Determination (2/3/17) (PDF, 102.71 KB)
02/02/2017 HIP 2.0 Monthly Report: October 2016 (PDF, 79.54 KB)
12/30/2016 Quarterly Report August 2016 - October 2016 (12/30/2016) (PDF, 381.72 KB)
11/25/2016 CMS Approval - Indiana NEMT Temporary Extension (11/25/2016) (PDF, 128.36 KB)
11/02/2016 HIP 2.0 NEMT Final Evaluation (11/02/2016) (PDF, 1.47 MB)
09/30/2016 Quarterly Report May 2016 - July 2016 (09/30/2016) (PDF, 391.32 KB)
09/16/2016 IN HIP 2.0 Emergency Room Copay 1916(f) Extension Letter (09/16/2016) (PDF, 65.9 KB)
08/12/2016 Completeness Letter (08/12/2016) (PDF, 65.59 KB)
08/12/2016 Indiana NEMT Extension Request (08/12/2016) (PDF, 1.85 MB) View Comments
07/29/2016 CMS Letter to Indiana on Lockouts and Prior Claims Payment (7/29/2016) (PDF, 86.47 KB)
07/20/2016 HIP 2.0 Monthly Report: July 2016 (07/20/2016) (PDF, 79.71 KB)
07/06/2016 HIP 2.0 Monthly Report: June 2016 (07/06/2016) (PDF, 81.57 KB)
07/06/2016 Interim Evaluation Report (07/6/2016) (PDF, 4.48 MB)
06/30/2016 Quarterly Report: Feb 2016- Apr 2016 (06/30/2016) (PDF, 534.17 KB)
06/10/2016 CMS letter to Indiana on Federal Evaluation DUA (06/10/2016) (PDF, 111.47 KB)
06/01/2016 HIP 2.0 Monthly Report: May 2016 (06/01/2016) (PDF, 75.05 KB)
04/29/2016 HIP 2.0 Year 1 Annual Report (February 2015-January 2016) (PDF, 1.06 MB)
04/28/2016 Indiana Letter to CMS on Lockouts and Prior Claims Payment (4/28/2016) (PDF, 1.91 MB)
04/20/2016 HIP 2.0 Monthly Report: April 2016 (PDF, 75.11 KB)
03/31/2016 Quarter Report - Nov 2015 - Jan 2016 (03/31/2016) (PDF, 458.77 KB)
03/21/2016 HIP 2.0 Monthly Report: March 2016 (03/21/2016) (PDF, 77.94 KB)
03/11/2016 NEMT Evaluation - Updated 3/11/16 (PDF, 1.65 MB)
02/26/2016 Indiana HIP 2.0: Evaluation of Non-Emergency Medical Transportation Waiver (02/26/2016) (PDF, 1.89 MB)
02/22/2016 HIP 2.0 Monthly Report: February 2016 (02/22/2016) (PDF, 78.55 KB)
02/04/2016 CMS Approved Emergency Department Copayment Protocol (02/04/2016) (PDF, 166.88 KB)
01/19/2016 HIP 2.0 Monthly Report: January 2016 (01/19/2016) (PDF, 77.86 KB)
12/29/2015 HIP 2.0 Provider Payment Report (12/29/2015) (PDF, 473 KB)
12/29/2015 HIP 2.0 Quarterly Report - Demo Year 1 Qtr 3 (12/29/2015) (PDF, 162.64 KB)
12/28/2015 Indiana HIP 2.0: Final Evaluation Design (12/28/2015) (PDF, 2.68 MB)
12/22/2015 HIP 2.0 Monthly Report: December 2015 (12/22/2015) (PDF, 77.83 KB)
12/22/2015 HIP 2.0 Response Letter (12/22/2015) (PDF, 72.73 KB)
11/30/2015 Presumptive Eligibility Standards Proposal (11/30/2015) (PDF, 116.11 KB)
11/24/2015 HIP 2.0 Monthly Report: November 2015 (11/24/2015) (PDF, 77.83 KB)
11/05/2015 HIP 2.0 Evaluation Letter (11/05/2015) (PDF, 790.12 KB)
10/29/2015 HIP 2.0 Draft Evaluation Design (10/29/2015) (PDF, 1.01 MB)
10/27/2015 HIP Prior Claims Payment Report (10/27/2015) (PDF, 571.3 KB)
10/23/2015 HIP 2.0 Monthly Report: October 2015 (10/23/2015) (PDF, 77.82 KB)
10/22/2015 HIP 2.0 Link Protocol - Approved (10/22/2015) (PDF, 370.57 KB)
10/08/2015 HIP 2.0 Quarterly Report - Demo Year 1 Qtr 2 (10/08/2015) (PDF, 219.97 KB)
09/21/2015 HIP 2.0 Monthly Report: September 2015 (09/21/2015) (PDF, 73.78 KB)
08/31/2015 HIP Passive Verification Report (08/31/2015) (PDF, 169.52 KB)
08/31/2015 HIP Presumptive Eligibility Standards Report (08/31/2015) (PDF, 120.56 KB)
08/12/2015 CMS Approval - POWER Account OP (08/12/2015) (PDF, 91.58 KB)
08/05/2015 HIP 2.0 Quarterly Report - Demo Year 1 Qtr 1 (08/05/2015) (PDF, 215.16 KB)
06/01/2015 Draft State Evaluation Design (06/01/2015) (PDF, 946.19 KB)
05/26/2015 HIP Link Draft Protocol (PDF, 1.64 MB)
05/14/2015 Technical Corrections Demonstration Approval (PDF, 545 KB)
05/01/2015 Emergency Room Copay Protocol (PDF, 315.06 KB)
02/26/2015 POWER Account and Copay Protocol (02/26/2015) (PDF, 536.44 KB)
01/30/2015 Approval Letter (01/30/2015) (PDF, 98.98 KB)
01/27/2015 HIP 2.0 Fact Sheet (PDF, 29.06 KB)
01/27/2015 HIP Approval (PDF, 372.24 KB)
08/22/2014 CMS Completeness Letter (PDF, 74.94 KB)
08/21/2014 Report to CMS Indiana Tribal Consultation (PDF, 137.35 KB)
07/02/2014 Healthy Indiana Plan Demonstration Application to Expand (PDF, 1.56 MB)
06/23/2014 Healthy Indiana Plan Expansion Proposal (PDF, 108.86 KB)
03/26/2013 Benchmark Equivalent Coverage Analysis (PDF, 2.47 MB)
Anthem Blue Cross and Blue Shield (PDF, 300.15 KB)
Health Benefit Booklet (PDF, 901.12 KB)
Healthy Indiana Plan Member Handbook (PDF, 2.09 MB)
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