HB 1592 also addresses concerns with Indiana’s new long-term care program for Medicaid members 60 years or older, Pathways for Aging.
(Abigail Ruhman/IPB News)
More than 10,000 Hoosiers are waiting for home- and community-based services through Medicaid waivers, including those waiting to go into assisted living facilities. A House committee approved a bill that aims to eliminate as many barriers to assisted living for older Hoosiers as possible.
House Bill 1592 does that in a number of ways – it would no longer allow the use of waitlists if the state has waiver slots available. This would have an effect on the current waitlist that the Family and Social Services Administration implemented in response to the 2023 Medicaid forecasting error.
The bill would also require FSSA to apply for a new waiver that would separate assisted living from all other home- and community-based services. And it would require FSSA to reimburse for services from the date of application rather than the date of approval.
Jill Stott, the executive director of Silver Birch Living, said the waitlist is more than just numbers — it’s people in every community in Indiana.
“It is the elderly who are caught in this limbo waiting for a decision that could mean the difference between housing, a hot meal or displacement and food insecurity,” Stott said.
An elder law attorney testified this legislation could save the state money in the long run since assisted living is less expensive than institutional care.
HB 1592 also addresses concerns with Indiana’s new long-term care program for Medicaid members 60 years or older.
Since Indiana launched the Pathways for Aging program last year, providers have flagged issues with the claims process. Now, a House committee passed legislation to create stricter guidelines for the insurance companies that facilitate the program.
The bill would require FSSA to audit the insurance companies, or managed care entities, behind the program. If those companies don’t meet certain performance standards or violate their contract, FSSA would be allowed to take administrative action against them.
Join the conversation and sign up for our weekly text group: the Indiana Two-Way. Your comments and questions help us find the answers you need on statewide issues, including our project Civically, Indiana and our 2025 bill tracker.
American Senior Communities' Katie Northington said her company is still waiting on claims from when the Pathways program first launched back in July, which is costing them time and money.
“We are not seeking special treatment,” Northington said. “We want to be paid for services rendered in a timely fashion. And we would like to see the [insurance companies] be held accountable by the state, as you are entrusting them with billions of dollars over the lifetime of this Pathways contract.”
Northington said her company had to double the staff in charge of claims billing.
Providers said they are waiting on tens of thousands of dollars from insurers. Northington said she had just one resident with over $40,000 of Pathways program receivables — and that is just one example of many.
She said her company received the temporary assistance set up by lawmakers during the last legislative session to address the transitional period, but it wasn’t enough to cover how much insurance companies haven’t managed to pay.
The bill would also create a centralized billing system so the state would have an easier way to manage and track provider claims to support providers in the future.
The bill now heads to the House Ways and Means Committee for consideration.
Abigail is our health reporter. Contact them at aruhman@wboi.org.
