IHCP Update: Published 3/26

The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at in.gov/medicaid/providers on March 26, 2020 (unless alternate date is noted).

News and Announcements (home page)
Amendment to Adult Mental Health Habilitation program receives CMS approval (posted March 25, 2020)

Provider Reference Modules
Obstetrical and Gynecological Services

• Updated the Prior Authorization for Total or Supracervical Hysterectomy section
• Added figures and information about the NOP Inquiry function in the Submitting a Notification of Pregnancy section
• Updated the HIV Testing of Pregnant Women and Newborns section
• Updated the High-Risk Pregnancy section and subsections to include physician assistants and APRNs as providers for high-risk pregnancy
• Added conditions to the Indications for Medical Necessity of Ultrasound section
• Updated the First-Trimester Fetal Nuchal Translucency Ultrasound section
• Updated Table 1 – Approved Medical Indications for a Medically Necessary Delivery Prior to 39 Weeks and 0 Days

Provider and Member Utilization Review

• Made updates in conjunction with new rule, 405 IAC 1‑1.4
• Updated the Program Integrity section with information from 42 CFR 455 and 456
• Updated the Reporting Fraud and Abuse section
• Updated the Referrals to the Medicaid Fraud Control Unit section
• Updated the Fraud and Abuse Detection System section to encompass underpayments as well as overpayments
• Added a link for Program Integrity training and information about IHCP publications to the Provider Responsibilities section
• Updated the Medical and Financial Record Retention section
• Updated procedures in the Reporting, Returning, and Explaining Overpayments section
• Updated the Program Integrity Audit Process section and subsections
• Added the Payments to the Provider section
• Updated the Prepayment Review section and subsections
• Updated the Payment Error Rate Measurement Audits section and subsections

Code Tables
The following code table updates are accessible from the Code Sets page:
Obstetrical and Gynecological Services Codes

• All codes were reviewed

​Check out these resources to stay up-to-date with the most recent changes at the IHCP.