Policy UpdatesHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMay 15, 2024

Clarification about the fee schedule update

Anthem recently reviewed the Indiana Medicaid Participation Attachment to the essential financial assistance (EFA) and non-hospital EFA contracts and will address some confusion regarding implementation of state fee schedule updates.

Notwithstanding any language in your Agreement that may suggest Anthem has up to 90 days to load a change in fee schedule, Anthem complies with all applicable laws and regulations also as set forth in your Agreement. Therefore, Anthem will, in accordance with the law, load changes to the Medicaid fee schedule within 30 days of the written notification from the state of the change in the fee schedule.

To avoid future confusion on this matter, we will be updating our Indiana Medicaid Participation Attachment for both the EFA and non-hospital EFA contracts to align more clearly with the state requirements on fee schedule updates. We anticipate that these updates will be available for new and renewing contracts on or after May 1, 2024.

Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Providers who are contracted with Anthem Blue Cross and Blue Shield to serve Hoosier Healthwise, Healthy Indiana Plan, and Hoosier Care Connect through an accountable care organization (ACO), participating medical group (PMG) or Independent Physician Association (IPA) are to follow guidelines and practices of the group. This includes but is not limited to authorization, covered benefits and services, and claims submittal. If you have questions, please contact your group administrator or your Anthem network representative.

INBCBS-CD-057181-24

PUBLICATIONS: June 2024 Provider Newsletter