How will PAs be handled for a member that changes programs?
If a member changes programs between Traditional Medicaid (FFS), Care Select, and Hoosier Healthwise, or between Hoosier Healthwise or Care Select plans, all existing PAs are honored for 30 days. This requirement will only be applicable if the member is re-assigned programs between Hoosier Healthwise and Care Select or the Traditional Medicaid FFS program. PAs approved by either of the two Care Select vendors or the FFS vendor will be available in IndianaAIM for claims processing by EDS. The PAs may be for a specific procedure, such as surgery, or for ongoing procedures authorized for a specified duration, such as physical therapy or home healthcare. The IHCP honors the PA for 30 days or for the remainder of the PA dates of service, whichever comes first. Requiring a duplicate authorization from the new plan places an additional burden on the provider and can result in delayed or inappropriately denied treatments or services to the member.
