In the Managed Care Organization (MCO) delivery system, the Office of Medicaid Policy and Planning (OMPP) pays contracted
managed care organizations a capitated monthly premium for each IHCP enrollee in the MCO's plan. The capitated premium covers
the cost of the care for services covered under the MCO program and incurred by IHCP enrollees in the MCO plan. The MCO assumes financial risk for services
rendered to members in its plan.
Managed Care Organizations (MCOs) are lawful entities authorized to operate a prepaid health care delivery plan (as an HMO)
that arrange, administer and pay for the delivery of health care services to members as designated by the OMPP. The care of Hoosier Healthwise members
enrolled in the MCO is managed by the MCO through its network of PMPs, specialists, and other providers of care who contract directly with the MCO.
The three MCOs listed below are currently contracted with the State of Indiana to serve the Hoosier Healthwise
managed care population.
The contract with the following MCOs expired December 31, 2006, but will continue to pay claims for services rendered prior to January 1, 2007.
For more information or questions about the Hoosier Healthwise MCO plans, please contact the MCOs directly. Contact
information for each of the IHCP-contracted MCOs can be found on the Managed Care Contacts page.
Additional information regarding the Hoosier Healthwise:
2007 MCO Contract Procurement Information
Auto Assignment Process - Hoosier Healthwise
Pharmacy Information
Prior Authorization Information
Behavioral Health Information
Hoosier Healthwise FAQs
IHCP Provider workshop - MCO Presentations
Member Grievance and Appeal Process
Managed Care Region Map
Acronyms
Managed Care Publications
Contacts
Forms
Generated Mailing Address
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