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Gov. Braun Signs Executive Order Related To Medicaid Costs For ABA Therapy




Fox 59
David Gay
February 20, 2025


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The office of Indiana Gov. Mike Braun announced on Wednesday that Braun
recently signed an executive order surrounding Medicaid costs for Applied
Behavior Analysis, or ABA, therapy.



According to a news release from Braun’s office, the order establishes a group
that would explore the containment of the cost for the therapy while
maintaining the quality of care for Hoosier children and young adults. ABA is a
therapy for the early treatment of autism.



Officials said that from 2017 to 2019, state Medicaid payments for ABA
increased from $14.4 million to $120 million. Over the next year, Braun’s
office said that payments are expected to increase even more, with $645 million
projected to be spent for around 8,000 children in 2026.


The release said that through an audit by the U.S. Office of the Inspector
General, officials found that Indiana made at least $56.5 million in improper
Medicaid payments for ABA. Officials said this was largely due to “problems
with credentialing for providers and a lack of evaluations, referrals and
documentation.”



“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,” Braun said in the release. “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 release said the working group of parents, legislators, experts,
physicians and ABA therapy providers will help find cost-containment solutions
to help minimize the costs of ABA to Medicaid. The group will be tasked with
presenting Braun with three “actionable recommendations” while evaluating:

* The best clinical care models to provide the right therapy, at the right
ages and in the right setting.
* Recommendations for a better coordinated experience for those who need ABA
therapy, 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
* Potential caps on hours for therapy provided each weeks
* Potential caps on the number of months a child can recieve therapy
* Creating an appeals process for extenuating circumstances
* Establishing new provider enrollment and billing requirements for ABA
providers to address issues identified in the audit.

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