302,000 participants will have to choose a different managed care plan
Medicaid enrollees in Indiana using MDwise will have to choose a different managed care plan.
Mitch Roob, Secretary of the state’s Family and Social Services Administration (FSSA) announced this week that MDwise will no longer serve as a provider for Indiana’s Healthy Indiana Plan (HIP) and Hoosier Healthwise programs, effective January 1, 2026.
MDwise has served as an Indiana Medicaid program provider for 30 years and it has the largest number of members – 302,000—among the state’s 4 managed care providers.
The statement from FSSA said the decision followed a comprehensive review of MDwise’s performance and costs.
“Indiana Medicaid exists to provide dependable, high-quality care for the Hoosiers who rely on it,” said Roob. “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.”
FSSA determined that ending the contract with MDwise was necessary to ensure the long-term strength and sustainability of Indiana Medicaid.
MDwise has filed a lawsuit to block the state’s termination of its 4-year contract that was slated to last through the end of 2026.
A MDwise statement said the state has acted improperly. “In August, the FSSA made sweeping claims regarding alleged breaches of contract and increased costs and issued MDwise a notice of intent to terminate for default. The allegations were non-substantive or technical in nature, such as not reporting a staffing change.”
“None of the allegations were about MDwise’s ability to provide and pay for quality health care services. MDwise demonstrated that all of the asserted breaches had been cured and that termination on the basis of default was wrong,” MDwise said. “Faced with the reality that its claims of default were not supportable, FSSA changed course and issued notice to terminate MDwise’s contract for “convenience” effective December 31, 2025. A termination for convenience is the same as a termination without cause.”
MDwise asked for a temporary restraining order to halt the termination, but it was denied. With the termination, MDwise will lay off 230 Indiana employees in January.
Medicaid’s MDwise members must choose a new health plan from the 3 remaining providers – Anthem, CareSource, or MHS – during open enrollment. Members who do not choose will be assigned to a plan, with the option to change within 90 days after January 1, 2026.
Members will receive letters with detailed instructions on how to select a new plan. For assistance, they can contact the Enrollment Broker for HIP at 1-877-GET-HIP9 (1-877-438-4479) and Hoosier Healthwise at 1-800-899-9949.
