What is a Policy Consideration request?
The Indiana Health Coverage Programs (IHCP) has a specific process for members, providers or other interested parties who wish to submit requests for policy consideration. For example, a policy consideration request may seek to add coverage for specific medical codes or services, revise a provider code set or revise a current medical policy. The Policy Consideration form is not used to submit requests for clarification or general IHCP policy questions.
- If you are a provider and have questions or seek additional information regarding IHCP policies and programs, please visit the Contact Us page on our website.
- If you are a member and have questions or seek additional information regarding IHCP policies and programs, please visit the Contact Us page on our website.
- If you are seeking reconsideration of a claim, see the Claim Administrative Review and Appeals provider reference module.
- If you are seeking reconsideration of a prior authorization request, please see the Prior Authorization provider reference module.
How do I submit a Policy Consideration request?
To submit a Policy Consideration request, please complete the online Policy Consideration form. With your submission, you will have the option to attach additional information or documentation to support your request. After the form has been submitted, the Office of Medicaid Policy and Planning (OMPP) will begin the review process.
How can I check the status of my request?
During the review process, you will receive automatic updates to the email on the request. At any point throughout the process, you can view all submitted requests and the status of each request from the View Existing Requests tab on the new online portal. If you have issues with the website or additional questions, you may email PolicyConsideration@fssa.in.gov.
After a determination is made on your request, you will receive an email with a determination letter and explanation. If the request is approved, you will be notified that the request is moving through the implementation process. If the request is denied, you will receive an explanation for the denial. A denied request may be submitted for a new consideration following a period of 18 months from the date of the decision or on release of new studies that would support your request.
Note: Approved policy consideration requests will not be applied retroactively.
To access the submission form and find additional information, please visit our Policy Consideration Request Form website.
If you have questions about this process, please email PolicyConsideration@fssa.in.gov.