Bill would set aside leftover Medicaid home care money for waitlists

Indiana would set aside certain leftover Medicaid waiver money in a fund for people on waiver waitlists. The fund is for people waiting for Medicaid services that provide care at home or in the community. Only unspent, uncommitted money budgeted for these waivers that would otherwise return to the state general fund would enter the fund. The state could use the fund for training, equipment, short-term help, and other supports; help for any one person is not guaranteed. The transfer rule covers state fiscal years ending June 30, 2026, and later, although the section says it takes effect July 1, 2026.

The state would send monthly payment statements, and recipients would review them and report errors. This covers people receiving Medicaid services at home or in their community through a waiver. Statements would arrive electronically unless a recipient asks for paper. Case managers would help review statements and report or resolve errors when asked. Statements must start no later than January 1, 2027; recipients must report errors within 30 days of receiving each statement.

Waiver service providers would give recipients billing and service records when requested. This covers providers serving people through Medicaid home and community care waivers. A recipient could request a plain-language, itemized bill up to twice each calendar year. A recipient or legal guardian could request records of services delivered once each calendar quarter. The section says it would take effect July 1, 2026.

The state would explain Medicaid denials and check certain bank accounts during eligibility reviews. The notice rule covers people found ineligible for Medicaid; the bank account rule applies to decisions based on the value of property that counts toward eligibility. When eligibility depends on property that counts toward an asset limit, the state must review every bank account that is active and holds assets at the decision time. A denial notice must name each reviewed bank and show the account's last four digits. The section says it would take effect July 1, 2026.

The state would audit providers serving fewer than 10 waiver recipients. This covers providers serving fewer than 10 people through Medicaid home and community care waivers. The first audits target providers never audited by or for the secretary's office or audited by or for that office before July 1, 2021. Later audits must check accreditation and whether providers can keep services running for at least three months without payment. The first targeted audits must occur before July 1, 2028; annual audits begin after July 1, 2028.