Family Voices, a national grassroots network of families and friends, advocates for disability services that are family-centered, community-based, comprehensive, coordinated and culturally competent for all children and youth with disabilities. Family Voices Indiana seeks to share advocacy opportunities and updated information on issues that impact Indiana families of children with disabilities or special needs. www.fvindiana.org
There will be a temporary outage of the Hoosier Works Electronic Benefits Transfer (EBT) system on Saturday, September 26 beginning at 11:00 p.m. [EDT], as the Indiana Family and Social Services Administration (FSSA) moves its business from JPMorgan Chase to Xerox. Hoosier Works is the system Indiana uses to deliver Supplemental Nutritional Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) benefits. This outage affects all SNAP/TANF EBT cardholders. EBT card benefits are expected to be available againSunday, September 27 by 12:30 p.m. [EDT] after the system transition is complete.
During the temporary system outage, EBT cardholders will not be able to make SNAP purchases or access TANF benefits at any grocery stores or ATMs. EBT cardholders should plan to do their grocery shopping and/or make cash withdrawals before or after the transition period.
The state’s current provider, JPMorgan Chase, has decided to get out of the business of providing EBT card services, necessitating the move to a new provider (Xerox). Making the change from the old provider to the new provider requires a temporary system outage.
The system transition will not change EBT card benefits or PIN numbers, and SNAP/TANF clients will continue to use their current EBT cards after the transition. The customer service website will change to www.ebt.acs-inc.com. However, the toll free EBT customer service number [1-877-768-5098] will remain the same.
Your chance to comment on why you believe it’s important for ABA (applied behavioral
analysis) therapy to be a covered service under Medicaid will be at a public hearing on Thursday, Sept. 10.
Indiana FSSA is holding the hearing to discuss changes to coverage requirements for occupational, physical, respiratory and speech therapy services for children and youth under 21 and to add ABA to covered services, among other topics.
The meeting will be held at 1 p.m. Sept 10 at the Indiana Government Center South, 402 W. Washington St., Conference Center Room 14, Indianapolis.
The proposed rule sets the following requirements for ABA therapy:
1. The child is eligible for Indiana Medicaid.
2. The child is at least three years old and no more than 20 years old.
3. The child has been diagnosed with autism spectrum disorder by a qualified provider.
4. The child has had a complete diagnostic evaluation using standardized testing.
5. The child’s qualified provider recommends and refers the child for ABA therapy, including projected length of treatment.
Treatment plans are authorized for three months at a time, and the total treatment can last no more than three years. The rule also states qualifications for providers of ABA therapy. Other details of the plan can be found in the proposed rule, available in full at http://www.in.gov/fssa/4543.htm.
If you can’t attend the hearing, you can still provide written comments by sending a note to
Kim Crawford, 402 W. Washington St., Room W451, Indianapolis, IN 46204.
If you send written comment, put "COMMENT RE: LSA Document #14-337, Nursing Therapies and ABA Rule" on the envelope and the top of your note.
Changes to the CIH waiver will help build a sustainable system of supports and services for people with intellectual and developmental disabilities and their families. Below is a schedule of meetings across the state for providers, families, advocates and people with intellectual and developmental disabilities. The purpose of these events is to gather input on what is working well and thoughts on what residential supports and services people want to help them in achieving their desired outcomes and goals.
*Hosting location time for providers is 3:00-5:00 and for families it is 6:00-8:00.
Although increases in health care premiums have slowed in recent years (see our recent blog), they may increase more rapidly in the coming years. In addition, out-of-pocket costs may be on the rise. This blog examines why this could happen and what families can do to protect themselves against higher premiums and out-of-pocket costs.
Why Could this Happen? There are several reasons that health insurance premiums could increase. For one, there has been an increase in the use of health care services due to improvements in the economy and more people having insurance coverage due to the Affordable Care Act (ACA). When insurers must pay for increased use of services, those costs are often passed on to the consumer as premium increases. Also, insurers offering plans in the ACA exchanges may have set artificially low premiums initially to attract customers, knowing that consumers tend to stick with their insurance plans. Raising premiums is a way that insurers can offset initial low premiums. Other reasons include rising drug prices and the phase-out of ACA protections for insurers, costs which insurers will pass on to consumers to some extent. In addition, when employers face increased benefits costs, these will often be offset by making employees pay a greater share of premiums than they used to.
According to a recent Kaiser Family Foundation analysis of preliminary 2016 premiums in 10 cities, costs for the lowest and second-lowest cost silver plans – where the bulk of enrollees tend to migrate – are changing relatively modestly in 2016, although increases are generally bigger than in 2015. BUT, the plans which had the lowest cost last year may not be the same plans that have the lowest cost this year. In other words, to stay in the most affordable plans, a consumer may have to switch plans or insurance companies in most of those cities.
Generally, there is a trade-off between premiums and out-of-pocket costs. To save money on insurance premiums, employers may choose plans with higher out-of-pocket costs for employees. In the exchanges, plans with lower premiums are likely to have higher out-of-pockets costs.
What Can Families Do? To save on premiums -- > Shop around – don’t “stick” with a company just because it is familiar. > Make sure your family’s providers are still in your plan’s network. > Find out if any family members are eligible for Medicaid or CHIP; remember that enrollment for Medicaid/CHIP is year-round. > If you are buying insurance through an exchange, make sure you are receiving any premium tax credits to which you are entitled. > Remember that the cheapest plans have the highest out-of-pocket costs for families, so that may not be the best deal. See http://blogs.wsj.com/washwire/2015/05/21/the-value-trade-off-in-high-deductible-health-plans/. Although there are “catastrophic” plans for people under age 30, these only provide “bare bones” coverage.
To save on out-of-pocket costs – > If you are buying insurance through an exchange, make sure you are receiving any cost-sharing subsidies to which you are entitled. > Ask for generic instead of brand name prescriptions, or talk to your health care provider about less-expensive alternatives to your medications. > Check for errors in your medical bills (very common) and make sure your insurance is covering what it should be by carefully reviewing “explanations of benefits” you receive from your insurance company.* > Take advantage of any flexible spending accounts offered by your employer. > Consider using Health Savings Accounts, which are available for individuals with high-deductible plans. This allows consumers to set aside funds to pay for health care costs tax-free. If the funds aren’t used, they can be rolled over into the next year.
*See the earlier blog post, What The Insurance Jargon Means for Families, which explains how to make sure that you are being billed correctly and that your insurance plan is covering what it is supposed to cover. About 80% of medical bills include some errors. See also the resource within that blog post about questions you should ask before paying any medical bill. Families also may want to look at the NY Times review of “America’s Bitter Pill” which addressed how to understand medical bills, and how to appeal denial of benefits on claims.
In summary, families of children with special needs can pick the best plans by comparing five key areas: premiums, deductibles, copayments, coinsurance, and out-of-pocket maximums (also see Resources.) There are also application assistors and a telephone help-line available if families need help.
Help with Applications: https://localhelp.healthcare.gov/
Get help applying for coverage through HealthCare.gov: https://www.healthcare.gov/apply-and-enroll/get-help-applying/
Families USA: Price Transparency in Health Care: An Introduction: http://familiesusa.org/sites/default/files/product_documents/HSI%20Price%20Transparancy%20Brief_final_web.pdf
What Consumers Should Know About Rising Health Care Costs: http://time.com/money/3684959/steven-brill-bitter-pill-consumers/
Why is Healthcare So Expensive?: http://www.healthcarevaluehub.org/cost-and-quality-problems/why-healthcare-so-expensive/
This tip sheet is based on an ACA blog authored by Lauren Agoratus, M.A. Lauren is the parent of a child with multiple disabilities who serves as the Coordinator for Family Voices-NJ and as the southern coordinator in her the New Jersey Family-to-Family Health Information Center, both housed at the Statewide Parent Advocacy Network (SPAN) at www.spanadvocacy.org. More of Lauren’s tips about the ACA can be found on the website of the Family Voices National Center for Family/Professional Partnerships: http://www.fv-ncfpp.org/. -
Family Voices Indiana shares this opportunity to attend a public hearing about a proposed rule for ABA under Medicaid.
Notice of Public Hearing
Under IC 4-22-2-24, notice is hereby given that on September 10, 2015, at 1:00 p.m., at the Indiana Government Center South, 402 West Washington Street, Conference Center Room 14, Indianapolis, Indiana, the Office of the Secretary of Family and Social Services will hold a public hearing on a proposed rule which amends 405 IAC 5-22-1 to update the definitions of certain categories of necessary services; amends 405 IAC 5-22-6, 405 IAC 5-22-8, and 405 IAC 5-22-10 to make changes to coverage requirements for medically necessary occupational therapy services, physical therapy services, respiratory therapy services, and speech and pathology services for individuals under 21 years of age; amends 405 IAC 5-22-11 to update the licensure and supervision requirements for occupational therapy assistants in accordance with IC 25-23.5-1-6 and IC 25-23.5-3; and adds 405 IAC 5-22-12 to add applied behavioral analysis therapy services as a reimbursable component.
Pursuant to IC 4-22-2-24(d)(3), the Indiana Family and Social Services Administration’s (FSSA)
has determined that the proposed rule will impose requirements and may impose costs on regulated entities affected by the proposed rule. Regulated entities will be required to comply with licensure and supervision requirements for occupational therapy assistants as required by law under IC 25-23.5-3 and
IC 25-23.5-1-6. The proposed rule also adds ABA therapy services, which serve a public need by
promoting health. Regulated entities that want to provide ABA therapy services will be required to
comply with Medicaid regulations regarding Medicaid providers. All parties interested in the proposed rule are invited to attend the public hearing and to offer public comments.
In lieu of attendance at the public hearing, written comments may be sent to: FSSA, Attention: Kim Crawford, 402 W. Washington St., Room W451, Indianapolis, IN 46204. COMMENT RE: "LSA Document #14-337, Nursing Therapies and ABA Rule".
Copies of the proposed rule and this notice are now available on the Family Social Services Administration website at: http://www.in.gov/fssa/4543.htm
Copies of the proposed rule and this notice are now available and may be inspected by
contacting the director of the local county Division of Family Resources office, except in Marion County, where public inspection may be made at 402 West Washington Street, Room W451, Indianapolis, Indiana.
Copies of the proposed rule are now on file at the Indiana Government Center South, 402 West
Washington Street, Room W451 and Legislative Services Agency, 100 North Senate Avenue, Room N201, Indianapolis, Indiana and are open for public inspection.
Here is proposed language about ABA:
SECTION 6. 405 IAC 5-22-12 IS ADDED TO READ AS FOLLOWS:
Mark Your Calendars Now! The Division of Disability and Rehabilitative Services is sponsoring a series of town hall meetings across the state of Indiana to gather input on changes to the Community Integration and Habilitation (CIH) home and community based services (HCBS) waiver. Changes to the CIH waiver are an important part of CIH Transform, a multi-year systems change process underway to build a sustainable system of supports and services for people with intellectual and developmental disabilities and their families. For additional information on the multi-year change, please visit the CIH Transform web page
The town hall meetings will be held in the following locations on the following dates:
District 5 Indianapolis 9/9/15
District 4 Terre Haute 9/9/15
District 6 Muncie 9/10/15
District 1 Gary/Merrillville 9/10/15
District 2 South Bend 9/16/15
District 7 Evansville 9/16/15
District 8 Clarksville 9/17/15
District 3 Ft. Wayne 9/17/15
There will be morning meetings for providers and afternoon meetings for families and persons with intellectual and developmental disabilities, as well as advocates. Both meetings are open to anyone to attend and provide their input. The purpose is to gather input on what is working well and thoughts on what residential supports and services people would like to buy that would be helpful to them in achieving their desired outcomes and goals.
Additional details on times and locations will be posted on the CIH Transform website: Questions for people to think about and to help them prepare their comments will also be posted. We hope to see you at one of these meetings in September!