Indiana Grapples with Defining 'Medical Frailty' Amidst New Medicaid Work Requirements
Indiana is facing challenges in defining 'medical frailty' as new work requirements for its Healthy Indiana Plan (HIP), a Medicaid program, are set to take effect in January. Thousands of low-income Hoosiers, aged 19-64, who are insured through HIP, will be required to demonstrate 80 hours of work, volunteering, or schooling per month for three months prior to their application or redetermination to maintain coverage. An alternative is earning at least $580 monthly. While exceptions exist for those deemed medically frail, the federal Centers for Medicare and Medicaid Services (CMS) is redefining this term, creating uncertainty for the state. Sunshine Beam, director of the Division of Family Resources at Indiana FSSA, noted that individuals currently considered medically frail might not qualify under the new definition. An interim final rule from CMS narrows the definition to conditions significantly impairing the ability to meet work requirements, leaving states to determine specific qualifying conditions....
