Indianapolis News and Headlines


HIP member concerned about provider lists

Posted at 1:25 PM, Apr 19, 2016
and last updated 2016-04-19 22:04:10-04

A Seymour resident is raising concerns about the Healthy Indiana Plan and what he calls a “useless” list of medical providers on the state’s website.

HIP member Harlan Watkins contacted Call 6 Investigates after he went to the website, operated by the state Family and Social Services Administration, and tried to find a dentist for a cracked tooth.

The Healthy Indiana Plan 2.0 covers adults 19-64 who meet specific income levels, according to the state’s website.

Four out of the five providers listed for Watkins’ area do not accept the Healthy Indiana Plan 2.0 at all.

“I went to the website on the back of the card they give, I found the list online, and called everyone on there and nobody took it,” said Watkins.

Watkins works full time and cares for his ailing mother.

The one provider that did accept HIP in his area was an oral surgeon, not a regular dentist as he was seeking, Watkins said.

Call 6 Investigates made some calls and also found four out of the five providers listed for Watkins’ zip code did not accept HIP 2.0.

In fact, some dentists’ offices told RTV6 they’ve tried repeatedly to get off the list of HIP 2.0 providers.

“If you’re going to have a list of providers and then you find out those providers accept it, what good is the list in the first place?” said Harlan. “It’s basically useless.”

Harlan said many people might get frustrated and give up.

“That goes against the entire concept of the Healthy Indiana Plan,” said Watkins. “What good is it if the people who need it, low-income individuals like myself, or anyone else struggling to make ends meet, aren’t able to get the help that the state says is there?”

Call 6 Investigates reached out the Family and Social Services Administration for more information about provider lists.

FSSA spokesperson Jim Gavin said the database on is the entire provider enrollment list for all Indiana Health Coverage Programs, including HIP, Hoosier Healthwise, Hoosier Care Connect and traditional Medicaid.

“When a provider (doctor, dentist, etc.) wants to be a provider for any of our programs their first step is to enroll as an IHCP provider and then they will be listed in the online database,” said Gavin. “All dentists who are enrolled in our IHCP system will appear on the list.”

Gavin said it’s up to the doctor or dentist whether to accept a certain program, such as HIP 2.0.

“This does present a challenge in that the providers listed on the website will not all take all programs’ members,” said Gavin. “They could also decide on their own to accept members of one program and not another, and this will not change whether or not they’re listed in the database.”

Gavin said providers have to contact Indiana Health Care Programs to be removed from the database.

“This process involves submitting a specific form, and the providers are informed of this,” said Gavin. “Once the form is submitted, they are removed somewhat quickly from the database.  We also require them to revalidate their enrollment every five years as a proactive way to find out if any dentists are no longer interested in taking IHCP members.”

Gavin admitted that the disclaimed on the website needs to be updated and written more clearly.

“That request has already been submitted and the language will be changed soon,” said Gavin.

Harlan Watkins also expressed frustration that so few doctors and dentists accept the Healthy Indiana Plan.

Gavin said FSSA shares that frustration.

“Unfortunately participation among dentists in serving Medicaid and other state program members is traditionally low,” said Gavin. “We have been working to improve the entire provider network and added around 5,300 providers of all types in the first year HIP 2.0 was in operation. With dentists specifically, there are systemic challenges in every state – attracting dentists who will serve lower income members and keeping the enrollment databases updated.”

FSSA is also developing a new service provider portal that will help members, said Gavin.

“We are working to address these challenges on behalf of our health plan members,” said Gavin.

Watkins said after numerous phone calls, he was put in touch with a dentist who accepts HIP, with an office approximately 30-45 minutes from Watkins’ home.


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