Indiana - Assistive Technology Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The Indiana Family and Social Services Administration (FSSA) funds Assistive Technology through the PathWays for Aging, Health & Wellness (H&W), Traumatic Brain Injury (TBI), Family Supports (FSW), and Community Integration and Habilitation (CIH) waivers to provide devices and evaluations that reduce reliance on paid staff.

Approval requires passing the Office of Medicaid Policy and Planning (OMPP) HCBS Certification process before an applicant can submit an Indiana Health Coverage Programs (IHCP) enrollment application. Providers targeting the PathWays for Aging population must subsequently secure network contracts with at least one of the three designated managed care entities (Anthem, Humana, or UnitedHealthcare) to receive authorizations and reimbursement.

1. Service Definition and Scope

In Indiana, Assistive Technology (AT) under HCBS waivers includes devices, controls, or appliances that enable individuals to increase their abilities to perform activities of daily living or to perceive, control, or communicate with the environment in which they live. The service also covers the evaluation of the assistive technology needs of a participant, including a functional evaluation of the impact of the provision of appropriate assistive technology and appropriate services to the participant in the customary environment of the participant.

This service is strictly supplemental to the Indiana Medicaid State Plan. Any item or device that is covered under the State Plan Durable Medical Equipment (DME) benefit must be billed to the State Plan first, and waiver funds can only be utilized if the State Plan limits are exhausted or the specific item is explicitly excluded from State Plan coverage.

• Covered Devices: Communication devices, environmental controls, and specialized appliances that reduce reliance on paid caregivers.
• Evaluation Component: Funding covers professional assessments to determine the appropriate technology for the individual's specific functional deficits.
• Training Component: Includes training or technical assistance for the participant, or where appropriate, the family members, guardians, or paid staff on how to use and maintain the equipment.
• Maintenance and Repair: Covers necessary repair of devices purchased through the waiver, provided the repair is more cost-effective than replacement.
• Exclusions: Items that are not of direct medical or remedial benefit to the participant, or items considered standard household goods, are excluded.

2. Regulatory and Oversight Agencies

The Indiana Family and Social Services Administration (FSSA) is the umbrella agency overseeing all Medicaid HCBS waivers. Within FSSA, the Office of Medicaid Policy and Planning (OMPP) manages the initial HCBS Certification process and oversees the PathWays for Aging, H&W, and TBI waivers.

The Division of Disability and Rehabilitative Services (DDRS), specifically through its Bureau of Disabilities Services (BDS), manages the FSW and CIH waivers for individuals with intellectual and developmental disabilities. Provider enrollment into the MMIS is handled by Gainwell Technologies, the fiscal agent for Indiana Health Coverage Programs (IHCP).

• FSSA Office of Medicaid Policy and Planning (OMPP): Certifies HCBS providers and oversees aging/physical disability waivers (https://www.in.gov/fssa/ompp/).
• FSSA Division of Disability and Rehabilitative Services (DDRS): Oversees IDD waivers and maintains the provider pick list for those populations (https://www.in.gov/fssa/ddrs/).
• Indiana Health Coverage Programs (IHCP): The Medicaid enrollment and billing authority managed by Gainwell Technologies (https://www.in.gov/medicaid/providers/).
• Indiana Department of Health (IDOH): Maintains the Nurse Aide Registry used for mandatory staff background checks (https://www.in.gov/health/).

3. Gatekeeping Prerequisites: Who Can Even Apply

Indiana does not require a Certificate of Need for Assistive Technology providers, nor is there a closed enrollment window. However, the state enforces a strict sequential gate: no entity can apply for IHCP Medicaid enrollment as a waiver provider without first obtaining an approved OMPP HCBS Certification.

For providers intending to serve the aging population under the PathWays for Aging waiver, obtaining IHCP enrollment is only the midpoint. The final structural prerequisite to actually receive referrals and bill for services is securing a network contract with at least one of the state's designated Managed Care Entities (MCEs). Without an MCE contract, a PathWays certification yields no revenue.

• OMPP HCBS Certification: The mandatory first step; IHCP enrollment applications will be rejected without this active certification.
• MCE Contracting: Required for PathWays for Aging; providers must contract with Anthem, Humana, or UnitedHealthcare.
• DDRS Pick List Addition: Required for H&W, TBI, FSW, and CIH waivers; providers must contact [email protected] after IHCP enrollment to be added to the referral list.
• Business Registration: Applicants must be registered and in good standing with the Indiana Secretary of State before applying for OMPP certification.

4. Licensure and Certification Requirements

Indiana does not issue a distinct, standalone "Assistive Technology License" through a health department. Instead, the legal authority to operate as an AT provider is granted entirely through the OMPP HCBS Certification process. Providers must submit their application through the OMPP Certification Portal.

The certification process requires the submission of comprehensive operational policies, proof of commercial liability insurance, and organizational charts. The state reviews these documents against the Required Document Definitions to ensure the agency has the structural capacity to deliver waiver services safely.

• OMPP Certification Portal: The mandatory online system for submitting initial certification requests and adding services (https://omppproviders.fssa.in.gov/).
• Liability Insurance: Providers must upload current, active commercial liability insurance policies; quotes or templates are explicitly rejected.
• Policy Manuals: Must upload specific policies (e.g., Incident Reporting, Grievance) bearing the exact agency name matching the application.
• Required Document Definitions: A state-published guide detailing the exact criteria each uploaded document must meet to pass OMPP review.

5. Medicaid Provider Enrollment

Once OMPP Certification is granted, the provider must enroll in the Indiana Health Coverage Programs (IHCP) using the IHCP Provider Healthcare Portal. Assistive Technology providers typically enroll as Provider Type 32 (Waiver Provider) with the specific specialty code corresponding to Assistive Technology.

The enrollment process requires the submission of the OMPP approval letter, a signed IHCP Provider Agreement, and completion of Schedule C.3 regarding managing individuals. An application fee is required unless the provider has already paid it to Medicare or another state's Medicaid program for the current enrollment cycle.

• IHCP Provider Healthcare Portal: The Gainwell-operated MMIS portal for submitting the enrollment application (https://portal.indianamedicaid.com/).
• Provider Type 32: The standard IHCP classification for HCBS Waiver Providers.
• Application Fee: Required for institutional providers and certain DME/waiver types, adjusted annually by CMS.
• Schedule C.3: The specific section of the IHCP application requiring disclosure of all managing individuals and owners.

6. Staffing, Training and Background Checks

Under 455 IAC 2-6-2, all HCBS waiver providers must ensure that any employee, agent, or staff involved in the direct management, administration, or provision of services passes strict background checks before providing direct care. This applies to technicians delivering or installing assistive technology devices in a participant's home.

If the Assistive Technology service includes the evaluation component, the individual performing the evaluation must hold the appropriate active professional license in Indiana, such as a Physical Therapist (PT), Occupational Therapist (OT), or Speech-Language Pathologist (SLP), verified through the Indiana Professional Licensing Agency (PLA).

• Limited Criminal History: Must be obtained from the Indiana State Police central repository for all direct-contact staff.
• Nurse Aide Registry Check: Providers must verify through the Indiana Department of Health that unlicensed staff have no findings entered on the registry.
• Professional Licensing Agency (PLA) Check: Required to verify the active status of any licensed health professionals (e.g., OT, PT) performing AT evaluations.
• Universal Precautions: All staff must be trained in and utilize universal precautions as part of general HCBS provider qualifications.

7. Documentation, Policies and Records

Providers must maintain rigorous documentation to survive post-payment audits. For Assistive Technology, this includes maintaining the original invoice for the device, proof of delivery signed by the participant or guardian, and documentation of any training provided on the use of the device.

During the OMPP Certification phase, providers must upload specific operational policies. OMPP explicitly warns that uploading full, unseparated operational manuals multiple times will result in the application being rejected and set to expired.

• Proof of Delivery: A signed and dated receipt from the participant confirming the device was received in working order.
• Invoice Retention: Original manufacturer or vendor invoices must be kept to justify the billed amount, as AT is often manually priced.
• Targeted Policy Uploads: Policies must be separated and uploaded individually into the OMPP portal; bulk manual uploads are rejected.
• Warranty Records: Providers must maintain records of any extended warranties purchased with items over $500, as required by waiver limits.

8. Billing, Rates and Claims

Assistive Technology is typically reimbursed on a manually priced basis, meaning the provider is paid the invoice cost of the item plus a state-defined administrative markup, subject to annual waiver caps. Claims for FSW and CIH waivers are submitted directly to IHCP via the Provider Healthcare Portal.

For the PathWays for Aging waiver, claims must be submitted to the specific Managed Care Entity (Anthem, Humana, or UHC) that the participant is enrolled with. Prior authorization is universally required before purchasing or delivering any assistive technology device.

• Prior Authorization (PA): Mandatory for all AT purchases; the PA request must include the professional evaluation and itemized quotes.
• Manual Pricing: Reimbursement is generally based on the submitted invoice cost rather than a fixed fee schedule.
• Waiver Caps: AT is subject to annual or lifetime budget caps depending on the specific waiver (e.g., FSW has a strict annual overall cap).
• MCE Billing: PathWays claims must be routed through the respective MCE's clearinghouse, not the state MMIS.

9. Approval Sequence and Timeline

The approval sequence is strictly linear and cannot be done concurrently. The applicant must first prepare all policies and submit the OMPP HCBS Certification application. Only after receiving the OMPP approval letter can the provider initiate the IHCP enrollment application.

Once IHCP enrollment is active and a Medicaid Provider ID is issued, the provider must then complete the final step: contacting DDRS to be added to the pick list (for IDD waivers) or initiating credentialing and contracting with the three MCEs (for PathWays). The entire sequence typically takes 4 to 7 months.

• Step 1: OMPP Certification: Requires 30-60 days for document review and approval.
• Step 2: IHCP Enrollment: Takes 15-30 days once the OMPP certificate is attached to the portal application.
• Step 3: MCE Credentialing: Can take 60-90 days per health plan for PathWays providers.
• Step 4: DDRS Pick List: A brief administrative step requiring an email to [email protected].

10. Common Denials and Survey Findings

The most frequent cause of application denial at the OMPP Certification stage is submitting incomplete or improperly formatted documents. OMPP will automatically set an application to "expired" if it contains blank organizational charts, expired background checks, or policies bearing a different agency's name.

In post-enrollment audits, Assistive Technology providers are frequently cited for failing to document that the Medicaid State Plan was exhausted before billing the waiver. Auditors will recoup funds if a provider bills the waiver for a standard DME item (like a basic wheelchair) without a denial from the State Plan.

• Expired Documents: Uploading background checks or licenses that are out of date causes immediate OMPP application expiration.
• Agency Name Mismatch: Policies copied from another agency without updating the name will be rejected by OMPP.
• State Plan Overlap: Billing the waiver for items covered by the State Plan DME benefit results in full recoupment.
• Missing Proof of Delivery: Failing to produce a participant-signed delivery receipt during an audit invalidates the claim.

11. Key Contacts and Resources

Providers must interact with multiple state portals and help desks depending on their current phase in the sequence. The OMPP Certification Team handles the initial document review, while Gainwell Technologies manages the IHCP enrollment portal.

For PathWays for Aging, providers must utilize the specific provider relations portals for Anthem, Humana, and UnitedHealthcare to secure the necessary network contracts after IHCP enrollment.

• OMPP Certification Portal: https://omppproviders.fssa.in.gov/
• IHCP Provider Healthcare Portal: https://portal.indianamedicaid.com/
• IHCP Customer Assistance: 800-457-4584 for enrollment portal technical support.
• BDS Provider Services: [email protected] for DDRS pick list additions.
• Anthem Indiana Provider Portal: https://providers.anthem.com/indiana-provider/patient-care/pathways-aging
• Humana Indiana Medicaid Resources: https://www.humana.com/provider/medical-resources/indiana-medicaid

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