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Indiana - Adult Companion Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

In Indiana, Adult Companion Services are funded through the state's Medicaid Home and Community-Based Services (HCBS) waivers, including the Health and Wellness (H&W) Waiver and the Traumatic Brain Injury (TBI) Waiver, which are administered by the Division of Disability and Rehabilitative Services (DDRS). The service provides non-medical supervision and socialization to help adults remain safely in the community. Providers must be certified by the Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning (OMPP) through the OMPP Certification Portal before enrolling in the Indiana Health Coverage Programs (IHCP).

Currently, Indiana has enacted a temporary enrollment moratorium on new HCBS waiver providers for specific services, including home and community assistance and attendant care, effective August 1, 2026. This moratorium blocks new applications unless the provider qualifies for a limited exception based on member access needs. Providers must navigate OMPP certification, IHCP enrollment, and final waiver program enrollment with DDRS or managed care entities (MCEs) for the PathWays for Aging program.

1. Service Definition and Scope

Adult Companion Services in Indiana provide non-medical care, supervision, and socialization to individuals who require assistance to remain safely in their homes or communities. These services are designed to ensure the health, safety, and welfare of the participant while assisting in the acquisition, improvement, and retention of skills necessary for successful community living.

The service is covered under Indiana's Medicaid HCBS waivers, such as the Health and Wellness (H&W) Waiver, the Traumatic Brain Injury (TBI) Waiver, and the PathWays for Aging program. It is distinct from medical or personal care services, focusing instead on supervision and socialization.

2. Regulatory and Oversight Agencies

The primary oversight for Medicaid HCBS waivers in Indiana is the Family and Social Services Administration (FSSA). Within FSSA, the Office of Medicaid Policy and Planning (OMPP) handles provider certification, while the Division of Disability and Rehabilitative Services (DDRS) administers the H&W and TBI waivers.

For individuals aged 60 and older, the PathWays for Aging program is administered through Managed Care Entities (MCEs), which require separate contracting after IHCP enrollment.

3. Gatekeeping Prerequisites: Who Can Even Apply

Indiana has implemented a strict gatekeeping measure for new HCBS waiver providers. Effective August 1, 2026, the state enacted a 6-month HCBS Waiver Provider Enrollment Moratorium. This moratorium applies to specified services under the PathWays for Aging, Health and Wellness, Community Integration and Habilitation, Traumatic Brain Injury, and Family Supports Waivers, specifically affecting home and community assistance and attendant care.

During this moratorium, new enrollment applications are denied unless the provider qualifies for a limited exception. To seek an exception, providers must submit a narrative detailing how their enrollment addresses specific member access concerns in areas of need.

4. Licensure and Certification Requirements

Indiana does not have a distinct state license for Adult Companion Services. Instead, providers must obtain Medicaid HCBS Certification through the FSSA OMPP. This certification process ensures compliance with Indiana Administrative Code (IAC) and waiver-specific standards.

Providers must submit their applications through the OMPP Certification Portal, providing required documentation such as organizational charts, liability insurance policies, and background checks. All HCBS providers are also subject to the federal Settings Rule, with heightened scrutiny applied to certain settings.

5. Medicaid Provider Enrollment

After obtaining OMPP certification, providers must enroll with the Indiana Health Coverage Programs (IHCP). This is a mandatory step before finishing waiver program enrollment with DDRS or the MCEs.

Providers must complete the IHCP screening requirements. If certified under the H&W or TBI waivers, the agency is added to a pick list with DDRS. If certified under PathWays for Aging, the provider must enroll and contract with the designated MCEs.

6. Staffing, Training and Background Checks

Providers must adhere to strict staffing qualifications and background check requirements as outlined in the Indiana Administrative Code (460 IAC 6). All direct care staff must undergo criminal history checks through the Indiana Central Repository.

Staff must also complete specific training requirements, including defensive driving and first aid if transporting clients, and receive annual training on working with health-impaired adults.

7. Documentation, Policies and Records

Providers must maintain comprehensive documentation and policies to remain compliant with OMPP and DDRS standards. The OMPP Certification Portal requires specific policies to be uploaded during the application process.

Uploading full operational manuals multiple times is not accepted; providers must upload the exact policy required. Policies must accurately reflect the applying agency's name.

8. Billing, Rates and Claims

Billing for Adult Companion Services is processed through the IHCP for fee-for-service waivers (H&W, TBI) or through the respective MCEs for the PathWays for Aging program.

Rates and procedure codes are established by FSSA and published in the IHCP Provider Reference Materials. Providers must ensure claims align with the authorized person-centered service plan.

9. Approval Sequence and Timeline

The approval process involves three main steps: OMPP Certification, IHCP Enrollment, and Waiver Program Enrollment. Due to the current moratorium, new applications are generally denied unless an exception is granted.

For those eligible, the OMPP Certification Portal provides initial review feedback. Once certified, IHCP enrollment follows, and finally, DDRS pick list addition or MCE contracting.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied due to incorrect documentation submitted in the OMPP Certification Portal. Common errors include uploading blank documents, expired background checks, or policies with another agency's name.

Additionally, submitting full operational manuals instead of the specific required policy will result in the application expiring and requiring a resubmission.

11. Key Contacts and Resources

Providers should utilize the official FSSA and IHCP resources for guidance on certification and enrollment. The OMPP Certification Portal is the primary hub for application submissions.

For assistance with IHCP enrollment, providers can contact the IHCP helpdesk. For DDRS specific inquiries, the BDS Provider Services email is available.

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