As part of a collaborative workflow improvement project with stakeholders, the Indiana Health Coverage Programs (IHCP) is issuing a clarification to IHCP Banner Page BR201839. Members determined as retroactively eligible under Hoosier Healthwise aid categories do not receive a managed care assignment for the retroactive eligibility period. Instead, during the retroactive period, member benefits are covered through the fee-for-service (FFS) delivery system. However, the exception to this policy is for newborns whose mothers were enrolled with a managed care assignment on the date of the child’s birth. In this case, the baby is assigned to the mother’s managed care entity (MCE), retroactively effective to the date of birth. The mother’s and the baby’s coverage remains with the MCE during the baby’s retroactive period. Once a Member ID is assigned to the baby, providers may send claims for the baby’s care to the mother’s MCE. Prior authorization (PA) for services may be required.
Family Voices Indiana is a family-led organization that provides information, education, training, outreach, and peer support to families of children and youth with special health care needs and the professionals who serve them.