Indiana Medicaid Rate Update

Discussions have continued with Indiana Medicaid and the Division of Aging concerning future changes to Indiana’s Medicaid reimbursement system.  In particular, a move from RUGs III to RUGs IV is still being debated, in particular which grouper to utilize, and whether or not the Special Care Unit add-on will remain.  In a new twist to the discussions, Indiana Medicaid indicated it was concerned with the growth in the overall percentage of residents that are categorized in the Rehabilitation groupers.  As of the last reported data, 36% of all Medicaid residents were in a Rehabilitation RUG, which is up 6% in just the past 4 quarters.  Indiana Medicaid seems to be making overtures that a return of an end of therapy assessment may be coming.  However, the data presented to the association by Indiana Medicaid is not exactly clear and we will be having more detailed discussions with the agency on this issue.  Also, as mentioned last month, IHCA has been working on an outline of a LTC policy plan that Indiana Medicaid requested our engagement on.  The plan is meant to develop a road map to follow related to reimbursement changes, home and community based services rebalancing, quality initiatives, and overall funding.  IHCA has presented a draft of this outline to the IHCA Board of Directors and general support was given to the IHCA staff to proceed with the discussion with the state.