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Indiana Medicaid Proposes Rule Changes for Provider Enrollment


The Indiana Office of Medicaid Policy and Planning (“OMPP”) recently published a notice of intent to overhaul several components of its Medicaid program through an administrative rule.

The proposed administrative rule, known as LSA #18-251, would overhaul existing program integrity, Medicaid provider appeals and Medicaid enrollment requirements and rules. In general terms, the proposed ruling would change timely filing dates to match fee-for-service claims as well as update and streamline program integrity rules.

As of now, the details of the ruling are not known as a copy is not yet available. But the notice of intent states that the OMPP intends to repeal numerous existing administrative code provisions including provider enrollment requirements. Other provisions include:

  • Medicaid claim denials due to program abuse or fraud
  • Medicaid overpayments
  • Provider payments during appeals
  • Medicaid provider appeals
  • Medical record maintenance
  • Medical record disclosure requirements

It is likely, based on the above list of appeals, that the proposed rule will impact all enrolled Indiana Medicaid providers.

A public comment period on the proposed ruling will open when its text is published on the Indiana Register. Any interested provider will be able to submit written comment or participate in a public hearing. 

Providers can follow the progress of LSA #18-251 at the OMPP’s rulemaking docket or by checking the Indiana Register

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If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.

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