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July 16, 2021

By: Brandon W. Shirley, Stephanie T. Eckerle, and Meghan M. Linvill McNab

The Indiana Health Coverage Programs (“IHCP”) announced on July 1, 2021 that it will end (effective July 31, 2021) many temporary policy changes issued in response to the COVID-19 public health emergency. The announcement, published in agency bulletin BT202152, identifies the specific policies that are no longer effective after July 31, 2021. For the specified policies, beginning August 1, 2021, affected Medicaid providers will be subject to billing or documentation requirements in place prior to the public health emergency. Affected IHCP providers should carefully review the rescinded policies and any related service or documentation requirements to ensure compliance. This alert details some important considerations and best practices for affected IHCP providers. 

  • Affected Providers: the rescinded policies expressly impact acute care hospitals, home health agencies, and behavioral health providers offering intensive outpatient treatment and substance use disorder programs to Medicaid patients. 
  • Affected Billing Procedures: the rescinded policies will cause prior authorization restrictions that were suspended or relaxed during the public health emergency to revert back to their pre-COVID status.
  • Effective Dates: the rescinded policies take effect on July 31, 2021. IHCP providers may continue to rely on these temporary IHCP bulletins until July 31, 2021. Beginning August 1, 2021, IHCP providers must follow pre-COVID policies or any new policies implemented by Indiana Medicaid and any of its Managed Care Entities.  

The IHCP also implemented notable telehealth changes during the public health emergency that became law during the 2021 General Assembly Senate Bill 3. As such, the IHCP issued a separate bulletin, BT202142, for telehealth services on June 8, 2021 that are effective July 11, 2021. Under BT202142, IHCP policies will follow the newly amended telehealth law, Indiana Code § 25-1-9.5-6. Notable changes resulting from this policy change include the following: 

  • Eligible Providers. OMPP expanded the list of providers eligible to provide telehealth services to Medicaid patients. Many of these providers were only temporarily eligible to provide telehealth services during the public health emergency. This expansion is now permanent. 
  • Telehealth Modalities. OMPP expanded the telehealth modalities to include email, instant messaging, facsimile, and internet consultations or questionnaires only if the provider has established a relationship with the patient. Providers may also continue using secure video conferencing, remote store-and-forward technology, or remote patient monitoring for any patient, whether or not a relationship has been established. 
  • Audio-Only. Providers should be cautious about using audio-only telehealth services and continue to follow the guidance in IHCP’s BT 2020106 until further notified by IHCP. Audio-only telehealth was permitted during the public health emergency under federal and state waivers. The IHCP stated that it will continue to reimburse audio-only telehealth; however, Senate Bill 3 does not expressly define audio-only services as telehealth. If Indiana Medicaid providers continue to use audio-only telehealth services for Medicaid patients after July 11, 2021, they should pay close attention to future announcements from IHCP on audio-only telehealth and reevaluate the use of audio-only services as federal and state public health emergencies conclude. 

The following are best practices for Medicaid providers to prepare for these changes and to be better equipped for a potential Medicaid audit.

  • Carefully review the list of policy changes listed in the Bulletin to determine which, if any, have been used or relied on during the COVID-19 public health emergency. 
  • Review the effective dates of the policies listed in IHCP bulletins to determine when the change occurred to ensure compliance with applicable requirements before and during the policy change. 
  • Retain copies of the temporary COVID-19 policies in current bulletins for reference and use in case such policies are no longer publicly available after July 31, 2021. 
  • Review applicable Medicaid policies to determine whether any changes occurred during the public health emergency to ensure ongoing compliance beginning August 1, 2021. 
  • Verify that Indiana’s Medicaid Managed Care Entities have also rescinded similar Medicaid coverage policies effective July 31, 2021 and review their now applicable policies to ensure ongoing compliance. 

Please contact Brandon W. Shirley, Stephanie T. Eckerle, Meghan M. Linvill McNab, or your regular Krieg DeVault health care attorney if you have questions about this alert or your compliance with Indiana Medicaid policies. 

Disclaimer. The contents of this article should not be construed as legal advice or a legal opinion on any specific facts or circumstances. The contents are intended for general informational purposes only, and you are urged to consult with counsel concerning your situation and specific legal questions you may have. In addition, marijuana remains a federally illegal schedule I drug. All activities related to marijuana are currently illegal under the federal laws of the United States and nothing contained on this alert is intended to assist in any way with violation of applicable law.