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[Indiana] Cardiac and Musculoskeletal Surgical Quality and Safety Management Program in Partnership with TurningPoint
Act
by Nov 30, 2026
Effective date
Dec 1, 2026
Identified
Oct 1, 2026
Summary
Effective December 1, 2026, CareSource is expanding TurningPoint's Cardiac and Musculoskeletal Surgical Quality and Safety Management Program to Indiana Medicaid members (Healthy Indiana Plan and Hoosier Healthwise). Prior authorization is now REQUIRED for all cardiac surgeries and musculoskeletal/orthopedic procedures listed in the policy before service delivery. Claims without prior authorization will be denied.
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What to do
by Nov 30, 2026 · 8 steps
01Billing and clinical teams must register on the TurningPoint Portal (myturningpoint-healthcare.com) to access cardiac and musculoskeletal surgical policies and guidelines.
02Update billing workflows and EMR systems to require prior authorization for ALL cardiac and orthopedic surgical procedures listed in the policy (both inpatient and outpatient) for CareSource Indiana Medicaid members (Healthy Indiana Plan and Hoosier Healthwise).
03Create process checklist for rendering physicians and facility staff to obtain authorization via web portal (myturningpoint-healthcare.com), phone (317-576-2990 or 1-855-941-5272), or fax (463-213-1003) BEFORE service delivery for dates of service on or after December 1, 2026.
04Train front desk and authorization staff that emergency-related procedures do NOT require prior authorization.
05Facility providers must verify prior authorization is complete before patient admission.
06Implement tracking system to monitor authorization status.
07CONSEQUENCES: CareSource will NOT pay claims for services requiring prior authorization that was not obtained by the provider.
08Failed authorizations will result in claim denials and patient billing liability.
Original notice
[Indiana] Cardiac and Musculoskeletal Surgical Quality and Safety Management Program in Partnership with TurningPoint
caresource.com · Always check the source before changing claims.