Indiana - Housing Stabilization — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

Indiana does not cover tenancy support under a standalone "Housing Stabilization Services" Medicaid benefit, but instead funds housing search, landlord mediation, and retention planning through "Community Integration Services" and "Community Transition Services" under the Division of Disability and Rehabilitative Services (DDRS) Community Integration and Habilitation (CIH) Waiver and the Office of Medicaid Policy and Planning (OMPP) PathWays for Aging program. Providers seeking to offer these services must first secure HCBS waiver certification directly from OMPP before they are permitted to submit a Medicaid enrollment application.

Approval requires navigating a strict three-step sequence: OMPP HCBS Certification, Indiana Health Coverage Programs (IHCP) provider enrollment, and finally, managed care contracting. For providers serving the aging population under the PathWays program, enrollment is not complete until the agency secures active network contracts with the state's designated Managed Care Entities (MCEs), which control the authorization and reimbursement for these tenancy supports.

1. Service Definition and Scope

Because Indiana lacks a distinct "Housing Stabilization" service, tenancy support functions are billed under Community Integration Services (for DDRS waivers) or Community Transition Services. These services assist waiver participants in identifying, securing, and maintaining independent community housing.

The scope includes direct assistance with housing applications, negotiating with landlords, understanding lease obligations, and developing individualized housing support plans to prevent eviction or institutionalization.

• Service Nomenclature: Billed as Community Integration Services or Community Transition Services depending on the specific waiver.
• Covered Activities: Housing search, lease negotiation, landlord mediation, and tenant rights education.
• Transition Support: Assistance with moving logistics, utility setup, and initial household establishment.
• Retention Planning: Developing strategies to address behaviors or financial issues that jeopardize housing stability.
• Excluded Costs: Room and board, direct rent payments, and security deposits are generally excluded from HCBS reimbursement.
• Target Population: Individuals transitioning from institutional settings or those at imminent risk of losing community housing.

2. Regulatory and Oversight Agencies

HCBS providers in Indiana are regulated by divisions within the Family and Social Services Administration (FSSA). The Office of Medicaid Policy and Planning (OMPP) handles the overarching certification for HCBS waivers.

The Division of Disability and Rehabilitative Services (DDRS) specifically oversees providers operating under the CIH and Family Supports Waivers, setting the programmatic standards and conducting compliance reviews.

• Certifying Authority: FSSA Office of Medicaid Policy and Planning (OMPP) (https://www.in.gov/fssa/ompp/).
• Program Oversight (I/DD): FSSA Division of Disability and Rehabilitative Services (DDRS) (https://www.in.gov/fssa/ddrs/).
• Medicaid Enrollment: Indiana Health Coverage Programs (IHCP) (https://www.in.gov/medicaid/providers/).
• Managed Care Oversight: PathWays for Aging MCEs, including Anthem (https://providers.anthem.com/indiana-provider/patient-care/pathways-aging).
• Managed Care Oversight: Humana (https://www.humana.com/provider/medical-resources/indiana-medicaid).
• Managed Care Oversight: UnitedHealthcare (https://www.uhcprovider.com/en/health-plans-by-state/indiana-health-plans/in-comm-plan-home/how-to-join-indiana.html).

3. Gatekeeping Prerequisites: Who Can Even Apply

Indiana enforces a strict sequential gatekeeping process for HCBS providers. An applicant cannot simply enroll in Medicaid; they must first pass the OMPP HCBS Certification process.

For the PathWays for Aging waiver, even after OMPP certification and IHCP enrollment, providers are structurally blocked from billing until they successfully contract with the designated MCEs.

• Prerequisite 1: OMPP HCBS Certification approval is required before an IHCP enrollment application will be accepted.
• Prerequisite 2: Compliance with Indiana Administrative Code 460 IAC 6 for financial status and organizational structure.
• MCE Contracting Gate: PathWays for Aging providers must secure contracts with Anthem, Humana, or UnitedHealthcare to receive authorizations.
• Entity Formation: Must be a legally established entity registered to do business in the State of Indiana.
• Financial Solvency: Must demonstrate financial stability as outlined in 460 IAC 6-11-1 through 460 IAC 6-11-3.

4. Licensure and Certification Requirements

Providers must apply through the OMPP Certification Portal. This process requires the submission of comprehensive operational policies, organizational charts, and proof of insurance.

The state reviews these submissions against the Required Document Definitions. Applications containing generic policies or documents bearing a different agency's name are immediately rejected.

• Application Portal: Submissions must be made via the OMPP Certification Portal (https://omppproviders.fssa.in.gov/).
• Regulatory Standard: Must comply with 460 IAC 6 provider qualifications.
• Insurance Requirement: Must provide quotes or active templates for General Liability Insurance per 460 IAC 6-12.
• Policy Customization: Policies must be agency-specific; uploading full, unedited generic operational manuals results in application expiration.
• Service Selection: Providers must explicitly request certification for Community Integration or Transition services on the application.
• County Designation: The certification application must specify the exact Indiana counties the provider intends to serve.

5. Medicaid Provider Enrollment

Once OMPP certification is granted, the agency must enroll as a billing provider with the Indiana Health Coverage Programs (IHCP).

Enrollment is conducted through the IHCP Provider Healthcare Portal, where the agency links its new OMPP certification to its National Provider Identifier (NPI) and establishes Electronic Funds Transfer (EFT).

• Enrollment System: IHCP Provider Healthcare Portal (https://portal.indianamedicaid.com).
• Provider Type: Must enroll under the specific HCBS waiver provider type designated by OMPP.
• Required Attachment: The approved OMPP HCBS Certification letter must be uploaded with the IHCP application.
• Application Fee: Subject to the standard Medicaid institutional provider application fee unless waived by Medicare enrollment.
• EFT Enrollment: Mandatory setup of Electronic Funds Transfer for claims payment during the portal application.
• Revalidation: IHCP enrollment must be revalidated periodically, typically every 3 to 5 years.

6. Staffing, Training and Background Checks

Direct support professionals providing tenancy support must meet the qualifications outlined in 460 IAC 6. This includes strict background check mandates and foundational training.

Agencies must maintain a roster of qualified staff and ensure all personnel files contain primary source verification of background checks before any client contact occurs.

• Criminal History: Mandatory compliance with 460 IAC 6-10-5 Documentation of Criminal Histories.
• Registry Checks: Staff must be cleared through the Indiana Nurse Aide Registry and the state's sex offender registry.
• Basic Qualifications: Direct care staff must be at least 18 years old and possess a high school diploma or GED.
• Initial Training: Staff must complete state-mandated orientation, including incident reporting and individual rights.
• CPR/First Aid: Active certification in CPR and First Aid is required for all direct-facing personnel.
• Ongoing Training: Annual continuing education requirements must be documented in staff personnel files.

7. Documentation, Policies and Records

Indiana requires HCBS providers to maintain rigorous documentation to support both their certification status and their daily billing. OMPP provides a 'Required Document Definitions' guide that dictates exactly what policies must be in place.

Client records must clearly link the housing support activities provided to the goals outlined in the participant's state-approved service plan.

• Financial Records: Must maintain documentation proving financial status per 460 IAC 6-11.
• Organizational Chart: A completed, non-blank organizational chart must be maintained and submitted during certification.
• Service Notes: Daily documentation must detail the specific housing search or retention activity performed, date, and duration.
• Incident Reporting: Must have a customized policy for reporting adverse events to DDRS or the MCE within 24 hours.
• Record Retention: Medicaid records must be retained for a minimum of seven years.
• Policy Updates: Policies must be updated to reflect current Indiana Administrative Code and waiver appendix changes.

8. Billing, Rates and Claims

Billing for tenancy supports depends on the waiver. For DDRS waivers, claims are submitted directly to the IHCP MMIS. For PathWays for Aging, claims must be routed to the participant's assigned MCE.

Services are typically billed in 15-minute increments or as milestone payments, strictly governed by the prior authorization generated by the waiver case manager.

• Fee-for-Service Claims: Submitted via the IHCP Provider Healthcare Portal for traditional waiver participants.
• Managed Care Claims: Submitted to Anthem, Humana, or UHC clearinghouses for PathWays for Aging participants.
• Prior Authorization: No service can be billed without an active Notice of Action (NOA) or MCE authorization on file.
• Billing Increments: Community Integration is generally billed using specific HCPCS codes in 15-minute units.
• Rate Setting: Rates are established by FSSA and published in the IHCP HCBS Provider Reference Modules.
• Claim Timely Filing: Standard IHCP timely filing limits apply, typically 180 days from the date of service.

9. Approval Sequence and Timeline

The end-to-end process to become a fully billable provider takes several months due to the sequential nature of the approvals.

Providers must clear OMPP first, then IHCP, and finally the MCE credentialing phase, with each step requiring the approval letter from the previous step.

• Step 1: OMPP Certification Portal application submission and review (timeline varies based on document accuracy).
• Step 2: IHCP Provider Enrollment via the Healthcare Portal (typically 30-60 days after OMPP approval).
• Step 3: MCE Credentialing and Contracting for PathWays (can add 60-90 days post-IHCP enrollment).
• Initial Review Feedback: OMPP provides feedback during the initial review if document corrections are needed.
• Portal Expiration: Applications left inactive or with uncorrected generic policies will expire, requiring a complete restart.
• Go-Live: Billing can only commence once the MCE contract is fully executed and the provider is loaded into the MCE directory.

10. Common Denials and Survey Findings

OMPP explicitly lists common reasons for certification application rejection. Most stem from administrative carelessness rather than programmatic flaws.

During post-enrollment surveys, DDRS frequently cites providers for failing to maintain continuous compliance with background check rules or financial documentation.

• Denial Reason: Uploading expired documents, licenses, or background checks to the OMPP portal.
• Denial Reason: Submitting policies that contain a different agency's name (copy-paste errors).
• Denial Reason: Uploading blank documents or blank organizational charts.
• Survey Finding: Failure to secure primary source verification of criminal histories per 460 IAC 6-10-5.
• Survey Finding: Billing for housing support activities that are not explicitly authorized in the participant's service plan.
• Survey Finding: Lapses in required General Liability Insurance coverage.

11. Key Contacts and Resources

Providers must utilize the official state portals and reference guides to navigate the enrollment process. The IHCP Helpdesk is the primary contact for portal technical issues.

For PathWays for Aging, providers must engage directly with the provider relations departments of the three MCEs.

• OMPP Certification Portal: https://omppproviders.fssa.in.gov/
• IHCP Provider Healthcare Portal: https://portal.indianamedicaid.com
• IHCP Customer Assistance: 800-457-4584 for enrollment application support.
• Anthem PathWays Network: https://providers.anthem.com/indiana-provider/patient-care/pathways-aging
• Humana Indiana Medicaid: https://www.humana.com/provider/medical-resources/indiana-medicaid
• UnitedHealthcare Community Plan: https://www.uhcprovider.com/en/health-plans-by-state/indiana-health-plans/in-comm-plan-home/how-to-join-indiana.html

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