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HCBS Provider Frequently Asked Questions

HCBS Provider Frequently Asked Questions

The purpose for this FAQ is to inform HCBS providers with relevant information related to the Indiana PathWays for Aging program. This information is accurate as of October 2023, and FSSA will provide updated FAQs in the future as needed.

Eligibility, Enrollment, and Plan Selection

Service Plans/Processes


Other Services/Service Change Questions

  • Who will providers bill (claims) for under age 60 Medicaid clients?

    Providers will continue to bill through the IHCP portal as you do today.

  • Will SSBG/Choice processes stay the same?

    Current processes for SSBG/CHOICES will remain the same.

  • How will MCEs address network adequacy? Will MCEs help support transportation in rural areas?

    Each MCE is responsible for meeting network adequacy requirements and have their own transportation providers. FSSA requires MCEs to frequently and consistently monitor provider networks to proactively identify any network deficiencies, filling gaps and reporting on those metrics. MCEs are required to review of analytics reports to determine any network gaps, conduct ongoing monitoring of network access, network composition (including cultural and linguistic competency), provider compliance with access standards through surveys and member complaints, monitoring of single-case agreements (SCAs) to identify barriers with current providers and identification of new providers to include in the network. FSSA requires MCEs to have key staff positions for network development, dedicated Provider Relations team, and contracting experts across provider types who work in tandem with cross-functional leaders to assure the MCEs network strategy aligns with the comprehensive and complex needs of members.

AAA and Case Manager Questions

  • Can the member keep their current AAA service coordinator?

    Yes, if the member chooses an MCE that the service coordinator is contracted through.

  • What will the role of the Area Agencies on Aging (AAAs) be in the enrollment process?

    Until July, 2025, enrollment processes will remain the same where individuals receive an eligibility assessment from their AAA. If the individual qualifies, the AAA will provide a warm handoff to the Enrollment Broker (Maximus) for MCE selection. Beginning in July 2025, the Level of Care Assessment Representative (LCAR) with Maximus will complete the front-end level of care assessments for the Aging & Disability waiver and PASRR function. If the individual qualifies for PathWays, the enrollment broker will assist the member in selecting a MCE.

  • How will the AAAs fit into the new MCE model? Will the MCEs utilize a pick list similar to how CICOA currently does?

    AAAs can decide to contract with the MCE to provide service coordination services as subcontractors. It is also possible the MCE may employ independent service coordinators not affiliated with an AAA. MCEs are not required or recommended to utilize a pick list, as members in the PathWays program are encouraged to have choice in choosing their providers along with education about provider selection to ensure there is a good match between member and provider.