The Hardship: Integrating Medicare and Medicaid in One Shot
As of January 1, 2026, Indiana officially launched PathWays Dual Care, a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP). For IDD providers serving seniors (60+), this means the "carve-out" era is ending. You are no longer just billing Medicaid; you are now navigating a single plan that integrates both Medicare and Medicaid benefits under three primary MCOs: Anthem, Humana, and UnitedHealthcare.
RCM Insight: The Verification Blackout
The biggest RCM threat in 2026 is the MCE Assignment "Auto-Enrollment." If a member has a different Medicaid MCO than their Medicare D-SNP, the state automatically shifted them to match the Medicare plan by Jan 1. If your RCM team is billing based on 2025 eligibility data, your claims are hitting a brick wall. You must verify member assignment through the CORE portal daily to ensure you are contracted with the specific integrated plan assigned to the member.