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In May 2014, the Centers for Medicare and Medicaid Services approved the Family and Social Services Administration’s request to continue coverage for approximately 360 individuals with End Stage Renal Disease (ESRD) who were at risk of losing access to kidney transplant services as a result of the end of the Spend Down provision.
Individuals eligible for continued coverage under this option must also be:
CMS approved continued coverage for these individuals with an ESRD liability applied, calculated using the same methodology as spend down. As of August 2014, these ESRD liability amounts will begin. Prior to being subject to the liability amount, members eligible under this option will receive notice of their ESRD liability amount by mail. Like spend down, the ESRD liability amount for these individuals will be due to providers after services have been rendered.
FSSA will be requesting a three year extension of the current authority to continue providing Medicaid coverage to these individuals. Written comments regarding the proposal are being accepted until June 19, 2015 and can be submitted to the FSSA via mail at 402 West Washington Street, Room W374, Indianapolis, Indiana 46204, Attention: Amber Swartzell or via electronic mail at firstname.lastname@example.org.
Anyone newly diagnosed with ESRD should consult their transplant or dialysis provider about coverage options, or call the Indiana State Health Insurance Assistance Program (SHIP) at 800-452-4800.