Office of the Secretary of Family and Social Services Docket 250372 Notice

in-20250730-IR-405250372ONA: OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES

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Summary

Notice of Changes in Methods and Standards for Recovery Audit Contractors In accordance with public notice requirements of 42 CFR 447.205, the Indiana Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning (OMPP) publishes this notice of proposed changes to methods and standards governing recovery audit contractors. This public notice is from July 30, 2025 through August 29, 2025. The FSSA-OMPP proposes to seek the exemption to the requirement for states to contract recovery audit services to a third party. This change is effective October 1, 2025. FSSA utilizes the Fraud and Abuse Detection System contract under FSSA Program Integrity to monitor the Indiana Health Coverage Programs for fraud, waste, and abuse, as well as identify underpayments and overpayments of Medicaid claims under the state plan and under any waiver of the state plan. Indiana has adequate appeal processes in place for entities to appeal any adverse determinations made by FSSA Program Integrity. Indiana assures that the recovered amounts will be subject to the state's quarterly expenditure estimates and funding of the state's share. FSSA Program Integrity coordinates with all other state audit entities, as well as state and federal law enforcement entities and the CMS Medicaid Integrity Program. A copy of this notice is now on file at the Indiana Government Center South, 402 West Washington Street, Room W451, Indianapolis, Indiana and is open for public inspection....

The agency’s own summary, as published.

The rule, in full

365 words as published, July 30, 2025. View the original →

OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES Notice of Changes in Methods and Standards for Recovery Audit Contractors In accordance with public notice requirements of 42 CFR 447.205, the Indiana Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning (OMPP) publishes this notice of proposed changes to methods and standards governing recovery audit contractors. This public notice is from July 30, 2025 through August 29, 2025. The FSSA-OMPP proposes to seek the exemption to the requirement for states to contract recovery audit services to a third party. This change is effective October 1, 2025. FSSA utilizes the Fraud and Abuse Detection System contract under FSSA Program Integrity to monitor the Indiana Health Coverage Programs for fraud, waste, and abuse, as well as identify underpayments and overpayments of Medicaid claims under the state plan and under any waiver of the state plan. Indiana has adequate appeal processes in place for entities to appeal any adverse determinations made by FSSA Program Integrity. Indiana assures that the recovered amounts will be subject to the state's quarterly expenditure estimates and funding of the state's share. FSSA Program Integrity coordinates with all other state audit entities, as well as state and federal law enforcement entities and the CMS Medicaid Integrity Program. A copy of this notice is now on file at the Indiana Government Center South, 402 West Washington Street, Room W451, Indianapolis, Indiana and is open for public inspection. Also, a copy of this notice is now available and may be inspected by contacting the local county office of the Division of Family Resources, except in Marion County, where public inspection may be made at the Indiana Government Center South, 402 West Washington Street, Room W374, Indianapolis, Indiana. There will be no public hearing. Written comments may be directed to FSSA, Office of Medicaid Policy and Planning, Attention: Conner Ortman, 402 West Washington Street, Room W374, MS07, Indianapolis, IN 46207-7083 or by email to spacomment@fssa.in.gov. Correspondence should be identified in the following manner: COMMENT RE: RECOVERY AUDIT CONTRACTOR. Written comments will be made available for public inspection at the address herein of the FSSA-OMPP.