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• / About Indiana Medicaid 
•  Upcoming Initiatives 

INDIANA HEALTH COVERAGE PROGRAMS - UPCOMING INITIATIVES

Healthcare in Indiana Medicaid is changing! Watch this website, and Indiana Health Coverage Programs (IHCP) bulletins, banner pages, and newsletters for up-to-date information about major healthcare initiatives.

• ICD-10-CM - The International Classification of Diseases, 10th Edition, Clinical Modification, also known as ICD-10, is a diagnostic coding system that was developed by the World Health Organization (WHO) in the 1970's to replace ICD-9-CM, and was implemented by the WHO in 1993. Within Medicaid, this code set is scheduled to replace the current ICD-9-CM diagnostic code set October 1, 2014. The IHCP will implement some changes as early as October 1, 2013. To stay up-to-date on IHCP's transition plans and implementation directives, visit the ICD-10 Information page on this site.

• CAQH CORE - The IHCP is making updates to comply with the federally mandated Council of Affordable Quality Healthcare (CAQH) Committee for Operating Rules for Information Exchange (CORE). The CAQH CORE's mission, defined by the Affordable Care Act (ACA), is to use common business rules (operating rules) to promote interaction of healthcare trading partners and the exchange of healthcare-related information in a consistent, clear, and standardized manner, and in compliance with applicable laws and regulations. The first set of operating rules implemented January 1, 2013, refers to patient eligibility and claim status. Future operating rules regarding Electronic Funds Transfer (EFT) and Health Care Remittance Advice (ERA) transactions are scheduled to implement January 1, 2014. For more information about CAQH CORE, visit the CAQH CORE website at caqh.org/.

• New Indiana Medicaid Pharmacy Benefit Manager - Indiana's Office of Medicaid Policy and Planning (OMPP) has selected Catamaran Corporation as the new Pharmacy Benefit Manager (PBM) for the IHCP. Catamaran, the merger of SXC Health Solutions (SXC) and Catalyst Health Solutions, will assume the responsibilities of pharmacy benefit management and pharmacy claims processing starting in Spring 2013. Guidance regarding this transition will be provided in IHCP publications and noted on the New Indiana Medicaid PBM page under Pharmacy Services on this site.

• New MMIS - The IHCP is taking steps to design and implement a new Medicaid Management Information System (MMIS), currently referred to as IndianaAIM. The updated system will be more efficient, user-friendly and accessible, and better equipped to deal with the complexities of today's medical environment. It is anticipated the new MMIS system will be operational in July 2015.

• Physician fee increase for primary care services - The Affordable Care Act (ACA) provides for a temporary increase in Medicaid payments for qualifying primary care services rendered by qualifying self-attested physicians. The federally funded, temporary rate increase is authorized only for calendar years (CYs) 2013 and 2014. The difference between the increased rate and the current IHCP rate will be distributed to qualifying self-attested physicians in quarterly, supplemental payments for qualifying services rendered to members on a fee-for-service (FFS) basis. The payment methodology for qualifying services rendered to managed care members is to be determined.