FSSA: HIP cost-sharing will remain paused after federal ruling vacated program approval

Medicaid members on the Healthy Indiana Plan, or HIP, will not have monthly payments for the foreseeable future.

The Family and Social Services Administration made the announcement after a federal judge vacated the 2020 approval of an Indiana Medicaid program over a number of policies that act as barriers to coverage.

The ruling stems from a lawsuit filed against the federal government. It said a number of policies within HIP restrict access to coverage and services, including POWER account contributions, which are monthly payments required to access the version of HIP with better coverage, HIP Plus. Nonpayment could result in being knocked down to the basic plan or losing coverage entirely.

Indiana Medicaid Director Cora Steinmetz said Indiana does not agree with the ruling.

“While HIP members remain covered today for Medicaid, the ruling creates uncertainty regarding which services are covered and removes the authority for certain administrative aspects of the program's operation,” Steinmetz said.

The judge that issued the ruling said that because Medicaid members derive their eligibility through Indiana’s state plan, they would remain eligible even with the vacated approval.

READ MORE: Indiana can no longer charge monthly payments for HIP after federal ruling
 

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Cost-sharing was paused for Medicaid members at the beginning of the COVID-19 pandemic. As the state completed its “return to normal” or Medicaid unwinding process following the end of the COVID-19 public health emergency, the requirement was set to restart in July.

Last year, advocates sent a letter to the Centers for Medicare and Medicaid Services requesting it remove Indiana’s ability to continue these policies. In December, CMS decided it would not take action. It said doing so would be too disruptive during the Medicaid unwinding process, but it reserved the right to take action in the future.

FSSA said POWER account contributions, as well as copayments, will not be required for HIP while it works with attorneys and federal partners at the Centers for Medicare and Medicaid Services to explore “all legal remedies.”

Cost-sharing, including copayments and premiums, for the Children’s Health Insurance Program, or CHIP, and MEDWorks will resume as planned.

Abigail is our health reporter. Contact them at aruhman@wboi.org.