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2022-2023 HCBS Rate Review Projects

About this project

HCBS Rate Review Updates

FSSA met with stakeholders on May 31, 2023, and June 1, 2023, to share a rate project update as the state finalizes provider rate increases for the Family Supports Waiver and Community Integration and Habilitation Waivers ahead of the submission to federal partners at the Centers for Medicare and Medicaid Services. Please see the links below for additional information. FSSA will accept comments through June 16, 2023 at


Home- and community-based services rate review webinar (Oct. 31, 2022)

Frequently asked questions

Rate methodology project overview and background

Project goals and objectives

FSSA aims to develop rate methodologies and rates for the Division of Disability and Rehabilitative Services 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, 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 - 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
  • Reduce disparities - Analyze and quantify disparities in access, quality, site of care, and person-centeredness, then build payment structures to level the playing field

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 implement rate reviews for the DDRS during the fall and winter of 2022.

Additional information

In addition to encouraging stakeholder participation in future meetings, FSSA requests that stakeholders submit comments via email:

2022 HCBS Survey Information - DA

Purpose of survey

The purpose of this survey is to gather input to help build an understanding of provider costs and inform payment rate assumptions. The provider survey is an important part of the information/data being collected for the HCBS rate review. Stakeholder input is key to understanding service delivery and related costs, challenges, and opportunities. Data elements collected during the survey may include general information, cost structure, staffing, training, benefits, PTO, transportation, and service specific information.
The survey will be requested from each agency that has delivered an in-scope service within the last year.

How to participate

On November 28, 2022, an email was sent to each agency with a link to complete the survey. The email included a unique, random username along with the link to the survey. The password was delivered in a separate email. Please note, only one username/password combination was made available to each provider agency, and only one survey may be submitted per agency.

How to access technical assistance

There are a number of technical assistance tools available:

  • Survey PDF on landing page to use as a reference
  • Section instructions within the survey
  • Pop ups within the survey for more information, instructions, and/or examples
  • Training video with a survey walkthrough
  • FAQ

If technical assistance is still needed or if you are unsure if you should have received the provider survey, please email

When it is due

The survey is due at midnight on Friday, December 16, 2022.

Reminder emails will be sent at periodic intervals during the survey window.

Survey training for providers

Training video with a survey walkthrough

General process steps for survey:

  1. The primary agency contact designated by DA received two separate emails from Milliman on November 28, 2022 which invited them to participate in the survey and included unique usernames and passwords. The use of unique usernames and passwords will ensure the confidentiality of the respondent’s data throughout the process, while allowing the primary contact to move in and out of the survey, as needed, during the submission window.
    • Email #1: Provided a direct link to the survey and a username that the respondent will use to login.
    • Email #2: Contained a randomly generated alpha-numeric password.
  2. Respondents will be able to access and edit their survey submission until the survey closes at midnight on December 16, 2022. However, respondents are encouraged to submit the survey as soon as it is completed to reduce the number of “follow up” contacts required.
  3. After logging into the survey, respondents will be prompted to answer several general questions about their agency. After the initial general questions are completed, you will be able to navigate to the various sections within the survey via the Section Navigation page. The Section Navigation page will serve as your home page in the survey, to track progress and continue where you may have left off. Respondents can log off and log back in at any time and will return to the Section Navigation page each time they log back in. Respondents may also freely navigate between sections using this view.
  4. We encourage the primary contact to request help from colleagues (“collaborators”), if helpful for survey completion (additional details provided below).
  5. Respondents will have access to the full survey during the submission window, up to the point of final submission. The respondent will be prompted to review all submissions and complete any missing data fields prior to final submission.
  6. Once the survey has been submitted, a final message appears thanking the respondent for their participation and providing additional links to the website and email address. If additional clarification is needed, a follow-up email will be sent to the primary contact. Otherwise, no further action is needed after submission.
  7. At various points throughout the survey completion window, reminder emails will be sent to primary contacts who have not yet completed their survey. Milliman/Axon will also be able to see which agencies have not yet opened their surveys so that we can appropriately follow up and/or secure an alternate primary contact for that agency. Primary contacts can be reassigned, as needed, throughout the survey window. If your agency’s primary contact is no longer able to serve in this capacity, please contact

Frequently Asked Questions for the 2022 Division of Aging HCBS Rate Review survey

December 9, 2022

November 28, 2022

Note: These FAQs will be updated as needed during the survey administration period.

  • What is the purpose of the survey?

    The purpose of the survey is to capture an understanding of service deliver costs for providers of home and community-based services and to inform payment rate assumptions. Results from the survey will help inform the independent rate model that will be used to develop new rates for existing home and community-based services.

  • When will the survey be sent?

    The survey was released on November 28,2022 with a due date of December 16, 2022.

  • Who will receive the survey?

    A link to the survey will be sent via email to each provider agency (only one response per agency).

  • Who is the best person to complete the survey?

    The survey will ask questions about financial information and services provided. Milliman will send the survey to the primary contact on file. We encourage the primary contact to request help from colleagues. The primary contact is responsible for submitting the survey once all parts are complete. If the agency would like to change the primary contact, please contact

  • What type of data will be requested?

    The types of data requested will include service delivery costs, including those related to direct care/clinical care staffing and supervision, employee benefits, administrative costs, program support costs, overhead, and transportation. Data requested will be in aggregate, and specific to the services each agency provides.

  • How long will the survey take to complete?

    It is expected that the survey will take several hours to complete in its entirety. The length of time it takes to complete the survey will vary depending on the size of the organization and the number of home and community-based services provided.

  • Will survey responses be shared with participants?

    Individual survey responses will be aggregated to protect confidential business information. Milliman will document and share key aggregate responses as part of the development of the public report. This will include wage information, documentation time, travel time, caseloads, and other inputs that are key to the rate review.

  • Who can we contact if we have questions on how to complete the survey?

    If you have questions that are not addressed by the instructions or training video on this website, please send an email to

Frequently asked questions Division of Disability and Rehabilitative Services 2022 home- and community-based rate analysis, October 2022

Note: These FAQs will be updated as needed during the rate review process.

Any input and feedback regarding the rate analysis project can be provided to DDRS at

Your participation in the survey is much appreciated!


This document is intended has been prepared solely for the internal business use of the Indiana Family and Social Services Administration and the FSSA Division of Disability and Rehabilitative Services. Milliman understands that the information in this document will be shared with providers of DDRS services for the purpose of supporting the submission of survey data.

The contents of this document are not intended to represent a legal or professional opinion or interpretation on any matters. Milliman makes no representations or warranties regarding the contents of this document to third parties. Similarly, third parties are instructed that they are to place no reliance upon this information prepared for FSSA and DDRS by Milliman that would result in the creation of any duty or liability under any theory of law by Milliman or its employees to third parties.

The services provided for this project were performed under the signed Consulting Services Agreement between Milliman and DCS approved January 4, 2022.