Policy Consideration Requests
The Indiana Health Coverage Programs (IHCP) has a specific
process for members, providers, or other interested parties who
would like to submit requests for policy consideration. A policy
consideration request may seek to add coverage for specific medical
codes, revise a provider code set, revise a current medical policy,
or seek a resolution to a general question about Indiana
Note: If you are seeking reconsideration of a claim, see the
Administrative Review and Appeals provider reference
module. If you are seeking reconsideration of a prior authorization
request, please see the Prior
Authorization provider reference module.
To submit a request, please email PolicyConsideration@fssa.in.gov
and include a completed Policy
Consideration Request Form. You may also attach additional
information to support your request, if desired. Once the form has
been submitted, the Policy Consideration Team will begin the review
process. Do not send handwritten request forms.
Policy determinations can frequently be made within several
weeks; however, more complex requests may require additional time.
At any point throughout the process, you may email PolicyConsideration@fssa.in.gov
to receive an update on your request.
Once a determination has been made, you will receive an email
with the attached determination. If the request has been approved,
you will be notified that the request is moving through the
implementation process. If the request has been denied, you will
receive an explanation for the decision. A denied request may be
submitted for a new consideration following a period of 18 months
from the date of the decision or on release of new studies that
would support your request.
Please remember that approved policy consideration requests will
not be applied retroactively.
Consideration Request Form