Intermediate Care Facilities for Individuals with Intellectual Disabilities. Hoosier Care Connect members who are admitted to an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) shall be disenrolled from the Contractor and enrolled in traditional Medicaid. Before the stay can be reimbursed by the IHCP, the level of care must be approved by the State. The Contractor must coordinate care for its members that are transitioning into an ICF/IID by working with the facility. The Contractor is responsible for payment for up to sixty (60) calendar days for its members placed in an ICF/IID while the level of care determination is pending.
Intermediate Care Facilities for Individuals with Intellectual Disabilities. Hoosier Care Connect members who are admitted to an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) shall be disenrolled from the Contractor and enrolled in traditional Medicaid. Before the stay can be reimbursed by the IHCP, the level of care must be approved by the State. The Contractor must coordinate care for its members that are transitioning into an ICF/IID by working with the facility to ensure timely submission of the request for PASRR, as described in the IHCP Provider Manual. The Contractor is responsible for payment for up to sixty (60) calendar days for its members placed in an ICF/IID while the level of care determination is pending.
Intermediate Care Facilities for Individuals with Intellectual Disabilities. A. The Contractor shall determine ICF-IID LOC according to Medicaid ICF-IID provider policy (8.313.2 NMAC, Long Term Care Services – Intermediate Care Facilities) and process (8.350.3 NMAC, Abstract Submission for Level of Care Determinations). The Contractor shall review initial and continued stay LOC requests using the HSD ICF-IID admission criteria. The Contractor shall close the review for discharges.
