In accordance with public notice requirements established at 42 CFR 441.304(f), The Indiana Family and Social Services Administration (FSSA), Office of Medicaid Policy and Planning (OMPP) intends to submit proposed amendments to the Aged and Disabled (A&D) waiver to the Centers for Medicare and Medicaid Services (CMS) for consideration.

A previous public comment period for this waiver was held from November 8, 2023, through December 14, 2023. Comments submitted during the initial public comment period were reviewed by the state. Additional changes are now being proposed to the waiver. Therefore, a second public comment period is being held to allow stakeholders an opportunity to provide input on the following modifications to this waiver.

Newly Proposed Amendments to the A&D Waiver

• Adjusts time frame for continuity of care for existing service plans by managed care entities.

• Clarifies the policies surrounding the allowance of services provided by legally responsible individuals.

• Revises the unduplicated participant counts.

• Makes language clarifications (as needed) in service definitions.

• Clarifies language on selection of entrants to the waiver.

• Revises provisions for annual rate adjustment.

• Makes other technical changes to waiver language to conform and align with existing waiver policies.

• Updates cost neutrality information.

Previously Proposed Amendments Included in the Initial Public Comment Period

• Makes minor changes to language in the waiver to align all 1915(c) waivers with matching language.

• Switches the government agency which oversees this waiver.

• Changes name to Health and Wellness (H&W) waiver.

• Changes waiver target population to serve individuals aged 0-59.

• Allows an option for specific categories of individuals aged 60 and older to remain on the H&W waiver.

Fiscal Impact (in millions):

The effective date of the waiver amendments is July 1, 2024, pending approval from CMS.

The 30 day public comment period for the A&D amendments will run from January 17, 2024, through February 16, 2024. Comments can be emailed to DDRSwaivernoticecomment@fssa.in.gov or mailed to:

The A&D amendments are available for review and public comment on the DDRS Draft Policies for Public Comment webpage (https://www.in.gov/fssa/ddrs/4205.htm). Hard copies of the proposed amendments are available upon request at the address contained herein. Additionally, copies of the proposed amendments are available at local Division of Family Resources offices.

Daniel Rusyniak, MD

Secretary

Family and Social Services Administration