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Lawmakers urge Holcomb to reconsider ABA rate cuts

By Whitney Downard, Indiana Capital Chronicle

Posted September 4, 2023

Parents protest proposed ABA therapy cuts outside of the Governor’s Mansion in Indianapolis on August 17, 2023. (Niki Kelly / Indiana Capital Chronicle)

A bipartisan group of lawmakers from both chambers sent a letter to Gov. Eric Holcomb earlier this week urging him to reconsider the proposed rate cuts for Applied Behavioral Analysis (ABA) therapy, a specialized form of treatment for autistic children.

The letter, authored by Shelbyville Republican Rep. Robb Greene, was signed by 13 senators and 29 representatives from across the state. Greene, a freshman legislator, shared the impact of ABA therapy on his young son.

Rep. Robb Greene, R-Shelbyville (Photo from the House Republicans)

“When my son, RG, was diagnosed with (Autism Spectrum Disorder) at age 3, he was functionally non-verbal. At an age when many parents are experiencing the joy that accompanies each milestone, we were told that our son had the developmental parity of a nine-month-old,” Greene wrote in a statement.

“… Within 2 months (of ABA therapy), RG went from very few vocalizations to the start of meaningful exchanges with us, his peers and his therapy team. Within the first year, he acquired many necessary life skills, such as beginning and mastering potty training, efforts made toward dressing himself and learning coping mechanisms that enabled our family to socialize together in more public settings,” Greene continued.

Greene said RG’s current ability to communicate basic needs and advocate for himself wouldn’t have occurred without “intensive” ABA therapy. His son now attends kindergarten at the family’s local public school.

“Simply put, ABA saved my son’s life,” Greene said.

The Family and Social Services Administration, through their Office of Medicaid Policy and Planning division, proposed establishing a rate standard for the treatment that would go into effect in late 2023 or early 2024. Prior to 2016, the state didn’t cover the service and thus didn’t have a precedent to set base rates.

Rather, the agency paid a flat 40% reimbursement, which caused payments to vary widely from provider to provider — averaging $91 for hourly rates but ranging from $46 to $222 hourly for the same services.

The newly established rates would be $55.16 per hour of ABA therapy administered by a registered behavioral technician — the majority of ABA services — or $103.77 for services rendered by a physician or other qualified health care professional.

Rep Robb Greene ltr 8.29.23 (003)

Greene acknowledged “the need to find a resolution on standardizing the reimbursement rate” but sought to find more common ground.

“Legislators, providers, stakeholders and families are ready to work with your administration to reach a collaborative decision on the shared goal of standardizing these reimbursement rates for ABA,” Greene wrote. “We believe that, together, we will find a solution that will serve the needs of both public policy and people.”

Previously, Holcomb said it was a “long overdue” process to establish a rate and that it would be “unfair” to everyone involved to slow down an ongoing process months in the making.

“We’ll make sure we get it right — we’ll make sure that we’ve done our research,” Holcomb said last month. “We know where we place in the country in terms of this reimbursement and so, again, we’ll arrive at a fair spot for families and for the state of Indiana that’s paying the bills.”