Language Translation
  Close Menu

HCBS Division of Aging Rate Methodology Project Frequently Asked Questions

Introduction:

These frequently asked questions relate to the Family & Social Services Administration Division of Aging’s Home- and Community-Based Services rate methodology project, where the division, in coordination with the broader FSSA organization, is developing a structured and transparent approach to establishing new rates for its Medicaid HCBS waiver program services.  The new methodologies will enable FSSA to achieve its policy goals and be in compliance with the Centers for Medicare and Medicaid Service’s requirements for sound and rigorous payment methodologies.

The FAQs relate to questions and comments received from stakeholders as of May 1, 2019. This FAQ will be updated at selected intervals based on newly submitted questions and comments.

  1. Division of Aging rate methodology project – general
  2. HCBS waiver program cost neutrality
  3. Division of Aging rate methodologies
  4. Value-based purchasing
  5. Provider survey

Division of Aging Rate Methodology Project - General

HCBS Waiver Program Cost Neutrality

  • What is the CMS cost neutrality requirement, and how does it impact Medicaid HCBS spending?

    “Cost neutrality” refers to a federal requirement that HCBS waiver program costs do not exceed the estimated cost to serve the same population in an institutional setting. Indiana must demonstrate to CMS that it meets this requirement on an annual basis.

  • Are State Plan services included in cost neutrality?

    Indiana’s cost neutrality demonstration includes all Medicaid costs for the waiver program populations, including both waiver services and state plan services. For example, in the case of a waiver participant, costs would include the cost of waiver services, physician services, prescribed drugs, home health services received through prior authorization, durable medical equipment such as a wheelchair, supplies such as diabetes testing strips or compression stockings, and other services for which Medicaid pays.

  • How does the A&D waiver program’s enrollment increases (under Olmstead) affect cost neutrality?

    Because it relies on the average cost per participant, Indiana’s cost neutrality expenditure limit expands when HCBS waiver program enrollment expands. As such, adding more participants to the waiver programs by itself does not adversely affect the state’s ability to demonstrate cost neutrality.

Division of Aging Rate Methodologies

Value-Based Purchasing

Provider Survey