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Committee advances CHOICE modernization bill to encourage Medicaid diversion, decouple low‑risk services and pilot prevention-focused interventions
Summary
House Bill 1391 would modernize the CHOICE home-and-community services program: decouple non‑medical services from Medicaid provider requirements, create a Medicaid‑diversion pilot, permit subcontracting for level‑of‑care assessments, and study service-area realignment. The committee passed an amended bill and recommended recommitment to Appropri-
The Health and Provider Services Committee passed an amended House Bill 1391 (Choice modernization) that seeks to make the CHOICE program more flexible, encourage Medicaid diversion, and improve connection between area agencies on aging (AAAs), providers and managed care.
Key changes and rationale
- Decoupling: The bill removes the requirement that certain non‑medical CHOICE services (for example, pest control or minor home modifications) be provided only by Medicaid-enrolled providers. Sponsors said decoupling will allow AAAs to contract more broadly, increase competition and lower local procurement costs for nonclinical services.
- Medicaid‑diversion pilot: The bill establishes a pilot to test a prevention‑focused, cross-sector model that targets costs and utilization drivers (e.g., home modifications, chronic-disease management and clinical partnerships). Ryan Keller (Thrive West Central) explained the pilot design and that the LEO Lab at Notre Dame will evaluate outcomes and cost savings.
- Level-of-care assessments: Beginning July 1 (per state transition plans), level-of-care assessments will be managed by a contractor (MAXIMUS); the bill permits that contractor to subcontract with AAAs to keep continuity and reduce disruption for older Hoosiers seeking services.
- Realignment study: The bill authorizes a study of possible realignment of AAA service areas to better reflect current needs and demographics.
Stakeholders and support
Area agencies, AARP Indiana and other aging advocates testified in favor, saying CHOICE has helped keep older Hoosiers in their homes and that targeted pilots and procurement flexibility could improve outcomes and lower long‑term Medicaid costs.
Vote and fiscal notes
The committee accepted an FSSA-requested conforming amendment (amendment 3) that clarifies implementation details and the bill passed 12–0, with a recommit to Appropriations. Sponsors said the bill is intended to operate within existing CHOICE funding and to look for savings through prevention and more efficient procurement.
Speakers recorded during the item included representatives of the Indiana Association of Area Agencies on Aging, Ryan Keller (pilot lead) and AARP Indiana.
