Indiana has instituted a six-month provider certification and enrollment moratorium on some home- and community-based services waiver providers after gaining approval from the Centers for Medicare & Medicaid Services (CMS).
The moratorium goes into effect on Aug. 1, 2026, and is designed to mitigate fraud, waste and abuse, according to Indiana Health Coverage Programs (IHCP).
IHCP is Indiana’s Medicaid program, which provides coverage through fee-for service and managed care delivery systems.
The move also restricts existing HCBS agencies from changing ownership, adding counties and expanding services subject to the moratorium, according to a state release. The IHCP stated it is enacting this moratorium under federal regulations which state that a Medicaid agency can implement a temporary enrollment moratorium for new providers if it identifies significant fraud, waste and abuse risk.
The moratorium affects providers of specified services under Indiana PathWays for Aging, Health and Wellness, Community Integration and Habilitation, Traumatic Brain Injury and Family Supports Waivers. Services affected include home and community assistance, attendant care, family and caregiver training and residential habilitation and support.
The moratorium does not halt all home- and community-based services. Certain waiver services are excluded, including adult day services, community transition, assisted living, case or care management and physical, occupational and speech therapy.
Providers with active enrollment applications that have completed all IHCP screening requirements before Aug. 1, 2026 may be eligible for enrollment during the moratorium period. Open enrollment applications that have not completed screening requirements by that date will be denied; applicants may reapply once the moratorium is lifted.
“The IHCP will consider limited exceptions to the moratorium to ensure sufficient member access to waiver services to areas in need,” the agency wrote.
Providers seeking an exception must meet all the state’s provider qualification requirements and submit a narrative detailing how the request can address access concerns.
The IHCP can extend the moratorium in additional six-month increments.
Indiana joins Minnesota, Arkansas, Ohio and Nevada in enacting enrollment moratoria for home-based care or hospice services, or both, to counter fraudulent activity.
Indiana’s HCBS moratorium comes after CMS enacted six-month moratoria on Medicare home health and hospice enrollments in May, citing significant fraud activity. In a fact sheet released alongside the moratoria announcements, the agency encouraged states to consider enacting their own moratoria to combat fraud, waste and abuse.
“CMS encourages each state to, as appropriate, implement a [home health agency] and hospice provider moratorium tailored to the specifics of their beneficiary population, as well as any geographic considerations,” the fact sheet read.
CMS also offered to consult with every state about implementing Medicaid-based and/or children’s health insurance program-based home health and hospice moratoria within their jurisdictions.