The Indiana Health Coverage Programs (IHCP) recently released updates that may impact physicians and their patients.

IHCP Works seminar Oct. 8-10
The Indiana Family and Social Services Administration (FSSA) and Gainwell Technologies invite IHCP physicians and their staff to attend the 2024 IHCP Works annual provider seminar. The free, in-person seminar is scheduled for Oct. 8-10.

Topics will include program overviews, specific program billing guidelines, and other important IHCP information. Sessions will be led by the FSSA/OMPP, Anthem, CareSource, Humana, Managed Health Services (MHS), MDwise, UnitedHealthcare, Acentra Health and Gainwell Technologies. For information about the full seminar lineup and to register, see BT2024139.

IHCP adds coverage for Adstiladrin (J9029)
On July 1, 2023, Healthcare Common Procedure Coding System (HCPCS) procedure code J9029 for nadofaragene firadenovec-vncg (Adstiladrin) was added by the Centers for Medicare & Medicaid Services (CMS), but the drug was not listed as participating in the Medicaid Drug Rebate Program (MDRP). The drug’s rebating status was changed effective Sept. 5, 2023.

Effective immediately, retroactive for dates of service (DOS) on or after Sept. 5, 2023, IHCP is adding coverage for Adstiladrin for eligible members 18 years of age and older. This coverage applies to medical claims for procedure code J9029 – intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose, and to Adstiladrin claims billed under the pharmacy benefit. For DOS on or after Oct. 1, 2024, prior authorization (PA) is required for coverage of Adstiladrin.

Learn more in BT2024138.