Medicaid HCBS

Indiana Home- and Community-Based Services Waivers

This program allows Indiana Medicaid programs to pay for services that are provided in a person’s home or other community setting, rather than a Medicaid-funded facility or institution. Persons must qualify for institutional care in order to be eligible for home- and community-based services. Waiver refers to the waiving of certain federal requirements that otherwise apply to Medicaid program services. The Division of Aging oversees two waivers; they are the Aged and Disabled Waiver and the Traumatic Brain Injury Waiver.

• Pathways and Waiver Transition Public Comment
• Where to begin to become a HCBS waiver provider
• Provider Compliance Reviews
  • PCR Webinar
  • PCR Webinar Slides
• Regulations:
  • The Aging Rule
  • HCBS waiver provider manual
• Current approved waivers:
  • Aged & Disabled Waiver, effective January 1, 2023
  • Aged & Disabled Waiver, effective February 1, 2020
    • Aged and Disabled waiver participant directed self-care amendment, effective July 1, 2020
  • Traumatic Brain Injury Waiver, effective January 1, 2023
  • Traumatic Brain Injury Waiver, effective February 1, 2020
• Waiver rates:
  • HCBS Waiver Rates Effective as of February 1, 2020  
  • 2022 allowable room and board rate
  • TBI Rate Amendment
  • A&D Rate Amendment

Aged and Disabled Waiver

The Aged & Disabled waiver provides an alternative to nursing facility admission for adults and persons of all ages with a disability. The waiver is designed to provide services to supplement informal supports for people who would require care in a nursing facility if waiver or other supports were not available. Waiver services can be used to help people remain in their own homes, as well as assist people living in nursing facilities to return to community settings such as their own homes, apartments, assisted living or Adult Family Care.

Traumatic Brain Injury Waiver

The Traumatic Brain Injury waiver provides home- and community-based services to individuals who, but for the provision of such services, would require institutional care. Through the use of the TBI, the Indiana Office of Medicaid Policy and Planning and the Indiana Division of Aging seek to increase availability and access to cost-effective traumatic brain injury waiver services to people who have suffered a traumatic brain injury. Indiana defines a traumatic brain injury as a trauma that has occurred as a closed or open head injury by an external event that results in damage to brain tissue, with or without injury to other body organs. Examples of external agents are: mechanical; or events that result in interference with vital functions. Traumatic brain injury means a sudden insult or damage to brain function, not of a degenerative or congenital nature. The insult of damage may produce an altered state of consciousness and may result in a decrease in cognitive, behavioral, emotional or physical functioning resulting in partial or total disability not including birth trauma-related injury.

A copy of the TBI waiver renewal can be found here.

Where to begin to become a HCBS waiver provider

Special notice to assisted living providers seeking Medicaid waiver certification

After reviewing the information provided above, you will need to complete an application for certification. A table indicating required documents for each waiver service is available below to review. Any additional questions or inquiries may be submitted to the Waiver Provider Specialist by phone at 317-232-4650 or by email at daproviderapp@fssa.in.gov.

• Aged & Disabled and Traumatic Brain Injury Waiver: Provider certification required documents

Please note: The Division of Aging office in Indianapolis is not set up to accommodate walk-ins. We urge you to use the tools and information on the website first. Again, questions may be emailed to daproviderapp@fssa.in.gov, as most questions can be resolved by email or phone call. If it becomes necessary to have an in-person meeting, division staff will schedule a meeting with you in advance.

The basic Medicaid Waiver Provider application for certification is available to download here (download will happen automatically when link is clicked) and the required W-9 is available here.

Please submit the final application and all required documents at daproviderapp@fssa.in.gov and paper applications will continue to be accepted and may be mailed to the address below.

ATTN: Waiver/Provider Analyst
Family and Social Services Administration
Indiana Health Coverage Programs
DA Home- and Community-Based Services Waivers
402 W. Washington St., Room W454, MS 21
P.O. Box 7083
Indianapolis, IN 46027

Once all documentation and forms are received by the Division of Aging, the Waiver Provider Analyst will review your Provider Application packet. There may be some follow-up questions or additional information needed. You may be contacted via email or telephone. It is important that you reply as soon as possible in order to avoid any unnecessary delays in processing your application. If the necessary documentation is not submitted in a timely manner, the application may be returned to you with the request to resubmit.

• If you are applying to be an Assisted Living provider or an Adult Day Services provider, you will also need to have an onsite survey conducted by the Division of Aging.
  • Adult Day Services Certification Tool
  • Assisted Living Services Certification Tool

• If you are applying to be an Assisted Living provider, you must complete a Disclosure for Housing with Services Establishments form to comply with IC 12-10-15. As of September 2018, these forms are submitted and maintained online. Please click the links below to complete the form by logging in with Access Indiana and to view instructions on submitting the form.

  • Disclosure for Housing with Services Establishments form
  • Instructions for completion of online Disclosure for Housing with Services Establishments form
• Upon completion of the application process through the Division of Aging, you will be notified by email that your certification has been approved or denied. Information regarding the appeal process will also be included, in the event your application is denied.
• If approved, you will then be directed to download your Indiana Health Coverage Programs Waiver Billing Provider Application and Profile Maintenance packet through Gainwell Technologies. (See HCBS waiver manual, Section 1. Helpful hints are also included). You will be notified by letter when the process is complete and your waiver billing number is assigned.
• NOTE: YOU MUST SUBMIT YOUR APPLICATION TO HP WITHIN 90 DAYS OF RECEIPT OF YOUR WAIVER PROVIDER CERTIFICATION FROM THE DIVISION OF AGING.
• You may begin providing services when you receive your Gainwell Technologies billing number, are activated in the waiver provider database and receive your Notice of Action.