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2019-2020 HCBS Rate Methodology Project

About this project


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Frequently asked questions

Stakeholders may view answers to frequently asked questions here.

Rate methodology project overview and background

Project goals and objectives

FSSA aims to develop rate methodologies and rates that comply with Centers for Medicare and Medicaid Services rules and that achieve:

  • Alignment and transparency - bring continuity and alignment across the rate methodologies and rates in each program, providing a consistent framework
  • Sustainability - facilitate adequate participant access to services, as required by CMS and be sustainable under the FSSA budget and operations
  • Promotion of person-centeredness and value-based purchasing - striving to align provider and participant incentives to achieve access to person-centered services, encourage appropriate utilization and drive healthy outcomes for all Home- and Community-Based Services participants

Rate methodology development process

FSSA has engaged Milliman to conduct HCBS rate methodology projects that are expected to culminate in the submission of waiver amendments and possible state plan amendments to CMS for federal approval. Rate methodology projects will involve the following phases:

  1. Project and stakeholder engagement planning
  2. Rate methodology development to achieve FSSA goals and objectives
  3. Rate setting and calculations based on final selected rate methodologies
  4. Waiver/state plan amendments and CMS approval process

Note that rate calculations will follow and be informed by the rate methodology project phase.

Stakeholder process

Balanced input from the full range of stakeholders is critical to this process. FSSA wants to hear from a variety of stakeholders, including providers and associations, participants, families, caregivers and advocacy groups, and other key state and federal government stakeholders.

Stakeholder engagement will include:

  • In-person meetings
  • Webinars
  • Surveys
  • Bulletins and FAQs
  • Rate methodology projects website and email address

In addition, per federal requirements, at the conclusion of each project there will be an official 30-day public comment period, followed by 30 days for FSSA to review and respond to public comment. CMS then has a 90-day approval process which may be extended based on their findings.

Tentative schedule

FSSA will sequence the rate methodology projects across HCBS programs to allow for meaningful stakeholder input, deliberate analysis and decision making and alignment across programs:

Rate methodology project Tentative project start
Division of Aging waiver programs March 1, 2019
Division of Mental Health and Addiction benefit programs Mid-2019
Division of Disability and Rehabilitative Services waiver programs (note: FSSA will first conduct a separate waiver redesign project) Waiver redesign: spring 2019
Rate methodology project:early 2020

Additional information

In addition to encouraging stakeholder participation in future meetings, FSSA requests that stakeholders submit comments via email: HCBS.Ratemethodology@fssa.IN.gov