Indiana Medical Frailty Definition Unfinished Three Months Before Work Requirements Start
Indiana's Family and Social Services Administration has not finalized its medical frailty exemption criteria for Healthy Indiana Plan (HIP) work requirements set to begin in three months. The exemption will determine which HIP enrollees — able-bodied adults ages 19-64 — are excused from work requirements due to medical conditions that prevent compliance. The delay creates uncertainty for thousands of low-income enrollees and health plans administering HIP. Medical frailty definitions are critical because they determine who faces coverage loss if work requirements are not met versus who receives an automatic exemption.
Undefined medical frailty criteria three months before implementation creates operational risk for Indiana MCOs managing enrollment changes and member outreach, and compliance uncertainty for providers serving HIP enrollees who may lose coverage.
Managed Care
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