The Indiana Family and Social Services Administration (FSSA) will be holding public hearings to accept public comment on a three-year Medicaid 1115 demonstration waiver (ESRD 1115 Waiver) renewal for individuals with end stage renal disease (ESRD) for calendar years 2016-2018.

Pursuant to 42 CFR Part 431.408(a)(2)(ii), FSSA hereby gives notice of the following public hearings. Both hearings will be accessible via web conference at http://webinar.isl.in.gov/fssain/.

FSSA will present the ESRD 1115 Waiver application to the Medicaid Advisory Committee on Thursday, May 21, 2015, at 1:00 p.m. at the Indiana Government Center South, Conference Center Room B, 402 West Washington Street, Indianapolis, Indiana 46204-2744.

ESRD 1115 Waiver Application Overview

The proposed ESRD 1115 Waiver requests a three year extension of the current authority to provide Medicaid coverage to eligible individuals with ESRD described below. Such coverage under the ESRD 1115 Waiver will also help ensure an individual's continued placement on the kidney transplant list. Due to their ESRD diagnosis, these individuals are not eligible to purchase Medicare supplemental coverage and are ineligible to receive a tax credit to purchase insurance on the Federal Marketplace. Therefore, Medicaid coverage, as authorized through this waiver, is the only supplemental coverage option available to ensure an eligible individual's continued placement on the kidney transplant list. FSSA estimates that approximately 350 individuals will benefit from this waiver request.

The ESRD 1115 Waiver preserves eligibility for individuals with ESRD with income over 150% of the federal poverty level (FPL) who were enrolled in Medicaid Spend Down and Medicare as of May 31, 2014. The waiver will also maintain eligibility and make eligible new applicants meeting the following criteria:

• are enrolled in Medicare;

• are diagnosed with ESRD;

• have income between 150% and 300% of the FPL;

• incur medical expenses which bring their income to the Supplemental Security Income federal benefit rate;

• have resources less than $1,500 for an individual or $2,250 for a couple;

• are not institutionalized; and

• meet all other Medicaid eligibility criteria, including, but not limited to, state residency and citizenship.

The State is seeking the authority under the ESRD 1115 Waiver to provide continued Medicaid coverage to this population until a new 1915(i) program is fully operational. The 1915(i) program will provide continued Medicaid coverage to eligible individuals with ESRD. FSSA anticipates that initial enrollment for the 1915(i) program will begin July 1, 2016, and all ESRD 1115 Waiver enrollees who qualify for the 1915(i) program will be transitioned by October 1, 2016. Additionally, the State is seeking authority under the ESRD 1115 Waiver to provide continued Medicaid coverage to individuals who are enrolled under the waiver but are expected to be ineligible to transition to the 1915(i) program once it is fully operational. This will include individuals who either do not meet the clinical criteria of the program or have income in excess of 300 percent FPL. Beginning July 1, 2016, when the 1915(i) program becomes operational, the State will no longer accept new enrollees under the ESRD 1115 Waiver. At such time, all new Medicaid applicants with ESRD who are otherwise Medicaid ineligible may apply for coverage through the 1915(i) program.

Written Comments

Copies of the ESRD 1115 Waiver renewal documents are now on file at the FSSA, Office of the General Counsel, 402 West Washington Street, Room W451, Indianapolis, Indiana 46204 and are open for public inspection. The full Public Notice and the waiver documents are also available online at http://www.in.gov/fssa/4898.htm.

Written comments regarding the ESRD 1115 Waiver may be sent to the FSSA via mail at 402 West Washington Street, Room W374, Indianapolis, Indiana 46204, Attention: Amber Swartzell or via electronic mail at amber.swartzell@fssa.in.gov. FSSA will accept public comments until June 19, 2015.