MedicaidCoverageLow impact
BT202651: FSSA clarifies home modifications for H&W, TBI and PathWays waiver providers
Indiana Medicaid (IHCP)·IN · PM&R (Physical Medicine & Rehab), Occupational Therapy, Physical Therapy·Managed Care
Effective date
Apr 7, 2026
We identified it
Jun 18, 2026
Summary
Indiana Medicaid clarified requirements for home modification providers under H&W, TBI and PathWays waivers, emphasizing that only basic medically necessary modifications are covered and that combining waiver funding with private funding for upgrades is not acceptable. Providers must notify BDS within 48 hours for H&W/TBI grievances and are responsible for replacing faulty work at no cost.
Action Required
Immediately: Home modification providers under Indiana Medicaid H&W, TBI and PathWays waivers must update billing practices to only submit claims for basic medically necessary modifications. Stop submitting bids that combine waiver funding with private funding for upgrades. Establish process to notify BDS.Help@fssa.in.gov within 48 hours for H&W/TBI waiver grievances.