In accordance with public notice requirements established at 42 CFR 441.301, the Indiana Family and Social Service Administration (FSSA) Office of Medicaid Policy and Planning intends to submit a 1915(b) waiver to the Centers for Medicare and Medicaid Services for consideration regarding the implementation of the new Medicaid managed care program, Indiana PathWays for Aging (PathWays).

Under the 1915(b) authority, the state will implement the PathWays program, which will serve members using a managed care delivery system. The program will serve individuals 60 years and older who qualify for Medicaid on the basis of age, blindness, or disability. Enrollees include members who have a full Medicare benefit, those in a nursing facility, and those who are receiving long term services and supports in a home or community based setting. The anticipated effective date is July 1, 2024.

From 2010 to 2030, the proportion of Hoosiers over 65 will grow from 13% to 20%. Indiana aims to reform the current system with the PathWays program to meet the growing demand and to create a program that will ensure member choice, drive quality, and manage cost. PathWays will ensure Hoosiers over 60 can choose to age in an environment that best suits them, be it at home or in the comforts of a quality long term care facility. Surveys show 75% of people over 50 prefer to age in their own homes, yet only 45% of Hoosiers who qualify for Medicaid do, and must navigate a complex system of care to do so. PathWays will be a managed care program used to integrate care to make it easier for Hoosiers and their families to navigate the health care system in order to drive outcomes in a transparent and accountable way.

PathWays builds on Indiana's long standing, statewide partnership with managed care plans that offer comprehensive benefits to Hoosiers. As of 2022, 85% of current Indiana Medicaid members (1.6M) receive services through managed care plans.

The 37 day public comment period will run from November 8, 2023, through December 14, 2023. Comments may be emailed to backhome.indiana@fssa.in.gov or mailed to the address below:

The Indiana PathWays for Aging 1915(b) waiver draft is available for review and public comment on the FSSA public notice webpage (https://www.in.gov/fssa/public-notices/). Copies of the waivers are also available at local Division of Family Resources offices. In-person consultations or phone calls are available upon request.

Daniel Rusyniak, MD

Secretary

Family and Social Services Administration