Two former state officials filed a “whistleblower” lawsuit that alleges several Indiana hospital systems and managed care entities have committed “tens, likely hundreds” of millions of dollars of Medicaid fraud. The former officials filed the lawsuit in early 2021 when they obtained access to analysis from Indiana’s “fraud and abuse detection system” contractor. The case was sealed until earlier this year.

Medicaid members in the Pathways for Aging program will have the opportunity to change plans during the first open enrollment period since the new program launched in July. Open enrollment starts on October 15.

A federal judge ruled the Family and Social Services Administration is required to provide necessary services for two medically complex children who were affected by changes to the attendant care program. The injunction was modified because of concerns that it could endanger Indiana’s Medicaid program as the lawsuit moves forward.

Indiana launched a new long-term care program in July for Medicaid members 60 years or older. Medicaid officials say they plan to monitor the Pathways for Aging program closely for a full year to catch any potential issues.

Indiana Medicaid officials say they’ve adjusted their processes for financial reporting and forecasting to avoid future budget problems after a $1 billion error last year. Officials are starting their forecasting process earlier than normal and will continue to adjust the forecast as they collect more data.

Thousands of people are still waiting for home- and community-based health services as Indiana processes people on waitlists for Medicaid waivers. The Indiana Family and Social Services Administration launched a dashboard to provide updates on the waitlists.

Several lawmakers want the Indiana Family and Social Services Administration to remove a policy from the Healthy Indiana Plan, or HIP, that has been linked to loss of coverage for Medicaid members. The calls to reevaluate POWER account contributions come as the state continues to appeal a federal ruling against the policy.

A federal judge has granted a motion that will allow Healthy Indiana Plan, or HIP, members to maintain their HIP Plus coverage while the state appeals a federal ruling. The program’s approval was vacated by the judge in June, but the state has been working to appeal the ruling.

Advocates say many Medicaid members are confused about how their coverage has been affected by a ruling that vacated the federal approval of the Healthy Indiana Plan, or HIP. The ruling highlighted several policies that act as barriers to coverage including monthly payments required for the version of HIP with better coverage, HIP plus.

The state made its first public arguments in a legal challenge to recent changes to Indiana’s attendant care program. The program provides services for people considered medically complex. Attorneys for the Indiana Family and Social Services Administration said parents aren’t allowed to provide this type of care under the state’s Medicaid program.