Porter calls for details on MDwise split as state owes $313M

State Rep. Gregory W. Porter is pressing the Indiana Family and Social Services Administration for answers after the agency abruptly terminated its Medicaid contract with MDwise, a move affecting roughly 300,000 Hoosiers enrolled in the Healthy Indiana Plan and Hoosier Healthwise programs.

FSSA announced last week that MDwise will no longer serve as a managed care health plan for Medicaid programs, requiring current members to select a new provider during the upcoming open enrollment period.

"Indiana Medicaid exists to provide dependable, high-quality care for the Hoosiers who rely on it," said Mitch Roob, Secretary of FSSA. "Our review found that, of the four plans, MDwise was both the most expensive and the lowest in quality. Federal rules require us to maintain at least three plans, and this decision allows us to meet those standards while safeguarding members' access to care."

Porter said the transition timeline raises concerns about continuity of care, especially during the holidays.

"Continuity of care is the most important thing," Porter said. "Less than two months is a short transition. Our case managers are overloaded, and it's the holidays. We can't let people fall through the cracks."

Porter also questioned the financial and legal implications of the split, pointing to an outstanding payment dispute between the state and MDwise. According to Porter, Indiana owes the company an estimated $313 million.

"This is starting to look similar to the IBM debacle. Indiana still owes MDwise $313 million. Will this lead to a long lawsuit? Indiana and IBM went back and forth for a decade," Porter said. "MDwise is already seeking an injunction and investigation. Legislators deserve the details since the FSSA's decision will lead to legal action."

Porter said he expects the matter to be addressed during the next State Budget Committee meeting. He also said he is preparing legislation aimed at increasing legislative oversight when major changes are made to Indiana's health coverage structure.

Porter argued that lawmakers should have been briefed before FSSA finalized its decision, given the number of Hoosiers affected and the potential budget impact of ongoing legal disputes.

A timeline for MDwise's full exit from the state's Medicaid system has not yet been released. FSSA has not publicly addressed the payment dispute referenced by Porter.

Members will receive letters with detailed instructions on how to select a new plan. For assistance, contact the Enrollment Broker for HIP at 1-877-GET-HIP9 (1-877-438-4479), Hoosier Healthwise at 1-800-889-9949 or visit mdwise.org/mdwise/helplink.

This reporting is made possible by a grant from the Indianapolis African-American Quality of Life Initiative, empowering our community with essential health insights. https://iaaqli.org/

Contact Health & Environmental Reporter Hanna Rauworth at 317-762-7854 or follow her on Instagram at @hanna.rauworth.

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