In accordance with Title 42 of the Code of Federal Regulations Sections 431.203, 431.210, and 431.213, and the 1115 waiver's Standard Terms and Conditions #9, Indiana's Office of Medicaid Policy and Planning (OMPP) is required to provide public notice of its intent to submit a phaseout plan for the end stage renal disease (ESRD) demonstration. The ESRD demonstration phaseout will be completed by December 31, 2024. The public notice period will run from 8/16/2023 to 9/15/2023.

The ESRD demonstration was initiated in 2015 to fill a coverage gap created by the end of Indiana's spend down program. That coverage gap no longer exists following the 21st Century Cures Act in 2021, which removed the enrollment restrictions for Medicare Advantage (Part C). As a result, OMPP proposes to sunset the ESRD waiver by December 31, 2024.

Fewer than 300 members still receive coverage through the ESRD waiver, and currently they are required to meet a monthly spend down to qualify for this coverage. OMPP proposes to assist those remaining members with the transition to Medicare Advantage before sunsetting the state's section 1115 demonstration titled End Stage Renal Disease. Medicare Advantage offers comparable coverage and will not require a monthly spend down prior to the start of benefits.

The Workforce Bridge program is currently attached to the ESRD demonstration. As part of the phaseout of the ESRD waiver, OMPP proposes to amend Workforce Bridge to the state's section 1115 demonstration titled Healthy Indiana Plan. The Workforce Bridge program is not currently in implementation status while FSSA focuses on transitioning Medicaid members to normal operations following the end of the continuous enrollment provisions that were in place during the federal public health emergency.

Indiana has published the draft sunset plan for public review at https://www.in.gov/fssa/hip/about-hip/hip-documents-and-resources/. A copy of this notice is now on file at the Indiana Government Center South, 402 West Washington Street, Room W451, Indianapolis, Indiana and is open for public inspection. Also, a copy of this notice is now available and may be inspected by contacting the local county Division of Family Resources office, except in Marion County, where public inspection may be made at 402 West Washington Street, Room W374, Indianapolis, Indiana.

There will be no public hearing. Written comments may be directed to FSSA, Office of Medicaid Policy and Planning, Attention: Madison May-Gruthusen, 402 West Washington Street, Room W374, MS02, Indianapolis, IN 46204 or by email to spacomment@fssa.in.gov. Correspondence should be identified in the following manner: COMMENT RE: ESRD PHASEOUT. Written comments will be made available for public inspection at the address herein of the OMPP.

Daniel Rusyniak, MD

Secretary

Office of the Secretary of Family and Social Services