Gov. Mike Braun signed an executive order establishing a work group to look at ABA services. He said the work group will include parents of children receiving ABA therapy, lawmakers, doctors, experts and ABA providers.
(Lauren Chapman/IPB News)
Indiana Medicaid paid more than $14 million for Applied Behavioral Analysis, or ABA, therapy service in 2017. But just two years later, it paid $120 million.
Gov. Mike Braun signed an executive order to convene a work group to address improper payments and rising costs while still protecting the service.
The rapid rise in spending on ABA therapy prompted a federal audit that projected the state could be paying $645 million in 2026. The audit also found more than $56 million of improper payments between 2019 and 2020.
Those improper payments were largely due to problems with credentialing for providers and a lack of evaluations, referrals and documentation.
Braun said the work group will include parents of children receiving ABA therapy, lawmakers, doctors, experts and ABA providers.
“We're going to do everything to take care of the underlying need to put the resources together, but we're not going to go into deficit spending to do it or anything else in our state government,” Braun said.
Braun said the work group will need to find innovative ways to bring down the costs of services while still providing quality care.
The work group is expected to evaluate a set of eight solutions laid out by Braun — including quality metrics for ABA services, potential caps for services per week and better coordinated care.
Then, he wants it to present him with three “actionable recommendations for ABA cost containment while maintaining quality.”
“We're going to make sure that everything we've built to date tries to stay intact,” Braun said. “I'm not making any guarantees beyond. I want to make sure that we get it under control and we can do it sustainably.”
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FSSA said it no longer plans to apply the lifetime limit retroactively — meaning that everyone’s three-year limit will begin on April 1, when the rule officially goes into effect.
Abigail is our health reporter. Contact them at aruhman@wboi.org.
