The State Budget Committee meeting on Friday saw a formal presentation of the new Medicaid reimbursement rate for a commonly used behavioral treatment for individuals with autism. However, the new rate has raised concerns among some Indiana legislators and parents, including professional doctors, who are skeptical about the effect it may have on accessibility to this crucial treatment. Doctors recommend Applied Behavior Analysis therapy as an effective way to enhance communication abilities and tackle behavioral issues.

However, providers and parents have strongly contested the initial declaration made in August about the proposed rate for ABA therapy under Medicaid, arguing that it will restrict access to this valuable treatment for children with autism.

The proposed cost

The proposed cost set forth by the Family and Social Services Administration stands at approximately $68 per hour. Based on FSSA’s provider survey, the mean hourly cost for ABA therapy is $91. This amount may prove to be challenging for providers to sustain their services within the state, according to Senator Fady Qaddoura (D-Indianapolis). In fact, Senator Qaddoura shared that he has a document in his possession from one of the providers stating that offering ABA therapy at a rate lower than $76 may potentially lead to crisis.

Initially, the Indiana Family and Social Services Administration suggested a rate of $55 per hour for applied behavior analysis therapy. However, after receiving feedback on this proposal, they decided to increase it to $68 per hour. This change was made in order to align rates among ABA providers and also because one provider shared that offering services below $76 may result in a crisis.

According to Shaw, the president of the Indiana Providers of Effective Autism Treatment — or InPEAT —, a significant issue that arises whenever we consider decreasing expenses is that some patients who need more substantial amounts of resources may end up being excluded from receiving adequate treatment. This preoccupies him greatly as a medical professional.

Parents like Rob Wilson, who are single fathers of four, highly commend ABA therapy for its profound impact on their child’s life. This therapeutic approach has enabled his daughter Olivia to acquire essential skills that have significantly improved her independence. However, the potential Medicaid rate cut could threaten their access to this crucial care. In a heartfelt statement, Wilson expressed his earnest desire for his child to experience joy and spend quality time with her family. He believes that ABA therapy is crucial for Olivia’s happiness and well-being as she navigates through her teenage years.

A substantial $4 raise in the current rate

To support the sustainability of ABA providers, Porter, Representative for Indianapolis, is pushing for a substantial $4 raise in the current rate imposed by FSSA. This increase would significantly reduce the obstacles faced by individuals seeking ABA services and ultimately benefit both providers and those in need of such therapy. Aside from the efforts being made in Indiana to support ABA therapy, Organizations in other states are also advocating for the accessibility and affordability of this vital treatment.

Nevada Autism Center is one such organization that has been actively pushing for insurance coverage for autism treatment. In addition to coverage, we strive to offer high-quality ABA therapy services for individuals with autism and their families.

Leave a comment

We accept

Latest Articles