Prior Authorization and Reimbursement Updates for 2011

Posted 19 January 2011 by aborgmeyer & filed under Provider News.

Prior Authorization Changes

We are excited to announce several upcoming Prior Authorization changes that will be effective February 1, 2011 for Hoosier Healthwise, Presumptive Eligibility and CHIP members. We are certain these changes will lessen administrative time.

• Therapy Services (Physical, Occupational & Speech), for members age 21 and older,  have a benefit limit of 25 visits per modality, per rolling 12 months with NO Prior Authorization required.
• Ancillary Services performed during an in-network observation stay (such as labs, X-rays, and scans), no longer require Prior Authorization.

 

Reimbursement and Benefits Adjustments

The Family and Social Services Administration (FSSA), Office Medicaid Policy and Planning (OMPP) recently announced reimbursement and benefits adjustments that are effective January 1, 2011. To assist our MHS providers, the recent changes are listed below and are available at the Indiana Health Coverage Program’s (IHCP) website:

 

What Services/Providers are Affected?

The following providers and services are affected by the rate and benefit adjustments:

• Attendant care services – BT201054, dated 11/17/2010
• Chiropractors – BT 201051, dated 11/17/2010
• Podiatry – BT201050, dated 11/17/2010
• Transportation – BT201057, dated 12/7/2010
• Vision – BT201049, dated 11/17/2010
• Physical, occupational, and speech therapies – BT201058, dated 12/7/2010

 

Where can you find more information?

Visit the Indiana Health Coverage Programs (IHCP) Provider Bulletins web page at http://provider.indianamedicaid.com and click on the bulletin numbers listed above for more information.