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Division of Aging Update You are receiving this email because you have elected to receive updates from the Indiana Division of Aging. Aged & Disabled Waiver Attendant Care providers asked to provide information In preparation for the claim billing and processing changes, all Aged & Disabled Waiver Attendant Care providers must submit the linked form electronically as soon as possible to identify current recipients being served where a Legally Responsible Individual (LRI) is being paid to provide Attendant Care services. A new electronic form submission is required for each recipient receiving attendant care services through the Aged & Disabled Waiver where any combination of paid staff is a legally responsible individual. Legally responsible individuals include: the parent of a minor child, or spouse of the recipient *Please complete one form for each individual receiving attendant care services and only in instances where a paid staff is an LRI. If an Attendant Care provider has NO instances of LRIs providing attendant care services, you must still submit a form indicating you do not have LRIs providing attendant care services at this time (as a reminder, no new LRIs are allowed to provide attendant care as of 1/17/24). Any questions related to the completion of this form should be sent to medicaid@fssa.in.gov with the subject line of LRI - Provider Attestation Form. Form information needed: In order to facilitate completion of the form, you should have the following information on hand to complete each form, available here, where an LRI is providing care: Recipient ID (RID) for each individual being served by an LRI The name(s) of the LRIs providing the attendant care service and The relationship of the LRI to the recipient (spouse or parent of minor child) The care manager currently assigned to the individual (available on the Notice of Action) The care manager’s company name Pursuant to your signed IHCP provider agreement, paragraph 25, you are required to provide the requested information in order to assure the appropriateness of IHCP payments made to the provider, the proper administration of the IHCP, and the provider’s compliance with all applicable statutes and regulations. Failure to comply with the requirements of your provider agreement can lead to sanctions provided for under 405 IAC 1-1.4-4, including suspension of payments or termination of the provider agreement. If you have already received and completed this request, you may disregard this email. Thank you for your cooperation. The Division of Aging is a program of the Indiana Family & Social Services Administration. If you have questions about Aging programs and services, visit us online at https://link.edgepilot.com/s/bcaada4d/Ow5mUSkjBUa-hQdG-lwe1Q?u=http://www.in.gov/fssa/aging.
You are receiving this email because you have elected to receive updates from the Indiana Division of Aging.
In preparation for the claim billing and processing changes, all Aged & Disabled Waiver Attendant Care providers must submit the linked form electronically as soon as possible to identify current recipients being served where a Legally Responsible Individual (LRI) is being paid to provide Attendant Care services. A new electronic form submission is required for each recipient receiving attendant care services through the Aged & Disabled Waiver where any combination of paid staff is a legally responsible individual. Legally responsible individuals include:
*Please complete one form for each individual receiving attendant care services and only in instances where a paid staff is an LRI. If an Attendant Care provider has NO instances of LRIs providing attendant care services, you must still submit a form indicating you do not have LRIs providing attendant care services at this time (as a reminder, no new LRIs are allowed to provide attendant care as of 1/17/24). Any questions related to the completion of this form should be sent to medicaid@fssa.in.gov with the subject line of LRI - Provider Attestation Form.
Form information needed:
In order to facilitate completion of the form, you should have the following information on hand to complete each form, available here, where an LRI is providing care:
Pursuant to your signed IHCP provider agreement, paragraph 25, you are required to provide the requested information in order to assure the appropriateness of IHCP payments made to the provider, the proper administration of the IHCP, and the provider’s compliance with all applicable statutes and regulations. Failure to comply with the requirements of your provider agreement can lead to sanctions provided for under 405 IAC 1-1.4-4, including suspension of payments or termination of the provider agreement.
If you have already received and completed this request, you may disregard this email.
Thank you for your cooperation.
The Division of Aging is a program of the Indiana Family & Social Services Administration. If you have questions about Aging programs and services, visit us online at https://link.edgepilot.com/s/bcaada4d/Ow5mUSkjBUa-hQdG-lwe1Q?u=http://www.in.gov/fssa/aging.