New regulations intended to reduce out-of-network balance billing, or so-called “surprise billing,” by Indiana physicians are set to take effect July 1, 2020. H.B. 1004 ensures that patients who go to an in-network hospital will not receive surprise bills from out-of-network physicians. As well, the new law requires hospitals and physicians to provide good faith estimates to patients when requested. READ MORE
During Indiana’s COVID-19 emergency declaration, IHCP is implementing temporary changes to provide flexibility for Indiana Medicaid providers and patients. Changes affect many areas of IHCP, including telemedicine, timely filing limits, provider enrollment, and more. Here is a brief overview of several of those changes. READ MORE
All Indiana Medicaid MCEs who choose to use a list of diagnosis codes to determine whether to cover emergency department claims must use a state-compiled standardized list beginning April 1, 2020. READ MORE
While the U.S. House and Senate continue to debate possible solutions to surprise billing on the federal level, here in the Hoosier state the Indiana General Assembly has taken matters into their own hands with a new House bill recently approved by a 99-0 vote. READ MORE
As we wrap up 2019, the Indiana Health Coverage Programs (IHCP) has released a variety of information Indiana healthcare providers need to know about billing Medicaid in 2020. We’ve created a short list of the top five things you should know. READ MORE
Indiana has temporarily halted the reporting requirements of its Medicaid work program, known as Gateway to Work, while a lawsuit challenging the program, Rose v. Azar, works its way through federal court. READ MORE
Beginning November 1, 2019, Anthem will reimburse CRNA services submitted with Modifier QZ for their Indiana Medicaid plans at 60 percent of the applicable fee schedule or contracted/negotiated amount. READ MORE
On October 1, some Hoosiers covered by Indiana’s Medicaid expansion program, Healthy Indiana Plan, now have to report 40 hours of work, education, or volunteerism to meet Indiana’s new Gateway to Work requirements. READ MORE
Providers billing Anthem Medicaid plans for multiple instances of the same surgical procedure for the same date of service by the same provider will need to make some adjustments to their claims in order to get paid correctly. READ MORE
Beginning October 1, 2019, Indiana Medicaid is making a few changes to their Anesthesia code set for traditional fee-for-service Medicaid. In the process, the payer also is reprocessing some claims denied in error as a result of the updates. READ MORE
