2024 Healthy Indiana Plan (HIP) Rate Equalization Project Reminder:
Date: 04/08/24
The Healthy Indiana Plan (HIP) Rate Equalization Project was implemented on January 1, 2024. We want to remind providers of the significant changes to provider reimbursement across all Indiana Medicaid programs, focusing on physician and ancillary services. This reimbursement update provides detailed insights into the key components and implications of the project. The initiative was formally introduced through Indiana Health Coverage Programs (IHCP) Bulletin BT202277 and BT2023149. MHS will follow the IHCP Professional Fee Schedule, which will be adjusted to align with 100% of Medicare rates, ensuring a standardized reimbursement structure.
Which programs are affected?
The HIP Rate Equalization Project exclusively impacts rates for physician and ancillary services listed in this manual. Rates for Hoosier Healthwise, Hoosier Care Connect, and fee-for-service (FFS) programs have been increased to 100% of Medicare rates, aligning them with HIP rates. The rate changes do not impact rates for inpatient hospitals, pharmacy, or outpatient hospital services.
Minimum Fee Schedule Implementation:
The 2024 IHCP Professional Fee Schedule will be a minimum fee schedule for all managed care plans. MHS will reimburse providers at or above these fee schedule rates for services covered under the member's benefit plan.
Implementation Details:
Starting January 2024, the IHCP Professional Fee Schedule, accessible from the IHCP Fee Schedules page, will be updated to reflect the current rates. The IHCP has outlines ancillary services below per bulletin BT2023149.
Ancillary services:
Durable medical equipment (DME) and medical supplies:
DME and medical supply codes that have a Medicare rate will be aligned with 100% of the prior year’s Medicare rates. DME and medical supply codes that do not have a Medicare rate, will receive an inflationary index increase. The rates utilized in the HIP Rate Equalization Project represent the lowest rate between the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) rural, DMEPOS urban, or competitive bidding area (CBA) file published by the Centers for Medicare & Medicaid Services (CMS) for Jan. 1, 2023.
Nonemergency medical transportation (NEMT):
FFS NEMT services will have a 20% rate increase. Managed care entities will continue to reimburse NEMT providers using their market-based rating, which does not vary by managed care program.
Dental:
Dental rates have been rebased for 2024 and reflect a 10% increase in aggregate dental spend. Dental age range and tooth range pricing will be discontinued.
Hospice:
Hospice rates are currently aligned with 100% of Medicare rates. There will be a minor modification in the additional room-and-board portion of the hospice payment as those will all be paid based on the state nursing facility rate.
Nursing facility and home health:
The rates for nursing facility services and home health agency services will be equalized to the reimbursement rates established for Medicaid FFS rates.
As always, thank you for being our partner in care. For additional information or clarification, please contact MHS Customer Service at 1-877-647-4848.