Last year, Indiana Medicaid established a standardized rate for ABA services despite concerns from families and providers about how that could impact access.
Indiana Medicaid Director Cora Steinmetz said the state is proposing another change this year. Medicaid members will be limited to 30 hours of comprehensive ABA services per week, for a maximum of three years.
“Following the maximum three year duration, ABA recipients would be permitted to continue limited hour behavior-specific, focused ABA services,” Steinmetz said.
However, some people currently utilizing the services might have already exhausted their three-year duration. Steinmetz said Indiana plans to give them time to transition.
“We are also proposing a continuity of care period until Sept. 1, 2025, for eligible ABA recipients,” Steinmetz said.
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Steinmetz said currently, the cost of ABA services are expected to increase despite previous efforts to limit growth. She also said the changes were prompted by a federal audit by the U.S Department of Health and Human Services Office of the Inspector General.
“Indiana was selected for this audit because the state was among the highest in ABA expenditures across the nation,” Steinmetz said.
Pending approval from the Centers for Medicare and Medicaid Services, Steinmetz said Indiana will propose these changes go into effect April 1.
In addition, FSSA recently implemented changes to ABA provider enrollment for state health plans, including Medicaid. These changes impact how providers are classified and the background check process for providers.
All new providers will have to complete the new background check requirements at initial enrollment. Existing providers will have to complete these requirements by July 1.
New background check requirements apply to all owners or individuals with 5 percent of more ownership in an organization providing ABA services.
Abigail is our health reporter. Contact them at aruhman@wboi.org.
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