Ind. IHCP Hospice Services Provider Reference Module, Section 3, Managed Care Members

Members who receive medical services under the managed care delivery system and who meet hospice criteria

are eligible for IHCP hospice benefits as follows:

• The Healthy Indiana Plan (HIP), Hoosier Care Connect and Indiana PathWays for Aging

(PathWays) programs include coverage for in-home and institutional hospice services for eligible

members. All covered hospice benefits for members enrolled in HIP, Hoosier Care Connect and

PathWays are the responsibility of the enrolling managed care entity (MCE). These members will

remain enrolled with their MCE for the duration of the hospice period, regardless of whether they

receive in-home hospice care or institutional hospice care.

• For Hoosier Healthwise members who meet hospice criteria, the member must first be disenrolled

from managed care and enrolled in FFS Traditional Medicaid before hospice benefits can begin. See

the Hospice Services for Hoosier Healthwise Members section for instructions on how to initiate the

disenrollment process. These members become eligible for hospice services the business day

following their disenrollment from the MCE.

The hospice provider must follow case-specific eligibility verification procedures when the client is a

member of an IHCP managed care program. See the Hospice Coverage and Authorization for Managed

Care Members section for more information.

Note: Program of All-Inclusive Care for the Elderly (PACE) participants should contact

their PACE program when considering hospice services. Some PACE programs will

provide end-of-life services upon request. If the PACE provider does not offer

appropriate end-of-life services, and the member wishes to elect Medicaid hospice

benefits, the member would need to be disenrolled from PACE and transitioned to

Traditional Medicaid fee-for-service coverage (if eligible) to access IHCP hospice

services. The PACE program will facilitate this process. Members choosing to

disenroll from PACE may risk losing Medicaid eligibility due to the enhanced income

allowances under PACE. PACE members are encouraged to consult with their PACE

provider when considering disenrollment for hospice care.