INDIANAPOLIS — Wednesday, Governor Mike Braun signed an executive order aimed at containing the Medicaid costs for Applied Behavior Analysis (ABA) therapy.
ABA therapy is instrumental in teaching skills such as speech and behavioral therapy to children on the autism spectrum. Many families rely on ABA programs, WATCH BELOW.
According to the Governor's office, medicaid payments for ABA therapy surged from $14.4 million in 2017 to $120 million in 2019 and an audit by the U.S. Office of the Inspector General revealed more than $56 million in improper payments.
“Indiana’s $1 billion Medicaid budget shortfall last year means we need to take bold action to contain costs where they are clearly getting out of hand. When the price our state pays for one service is soaring from $14 million to $120 million in just two years, with over $39 million of improper payments identified in an independent audit, something is clearly wrong and needs to be addressed immediately,” said Governor Mike Braun. “We’re taking decisive action to contain these massive cost increases while maintaining quality of care for the Hoosiers that rely on these treatments.”
The executive order establishes a working group of parents, legislators, experts, and ABA therapy providers.
Their mission, according to Braun, is tasked with evaluating the following solutions:
- the best clinical care models to provide the right therapy, at the right ages, in the right setting, to best serve children and families;
- recommendations for a better coordinated experience for children who need ABA therapy services, but in a financially sustainable manner;
- proper transitions for children as they grow in their educational, family and social settings;
- quality metrics for ABA therapy services;
- potential caps on hours of therapy services provided per week;
- potential caps on the number of months a child can receive therapy services;
- creating an appeals process for extenuating circumstances; and
- establishing new provider enrollment and billing requirements for ABA providers to address issues identified in the federal audit.
