Applied behavior analysis therapy is behavior-based, helping individuals with autism improve communication, socialization and development. Photo from Adobe Stock.

By Tim Spears and Joe Ulery
Indiana News Service

INDIANAPOLIS — In the face of Medicaid cuts, autism advocates in Indiana are focusing on protecting coverage of a popular therapy.

As News 8 reported, the Indiana Family and Social Services Administration will reduce Medicaid coverage of applied behavior analysis, or ABA therapy. Individuals will be limited to between 30-38 hours of ABA per week, depending on their diagnosis and will only be covered for a total of 36 months.

That three-year coverage cap was initially planned to be retroactive, but the FSSA changed course this past Friday following widespread pushback. The changes go into effect Tuesday, April 1.

Parents like Jana Tiede believe ABA coverage should be based on existing need, not how long a person has needed it.

“With the help of ABA she’s really starting to put together those social connections,” Tiede said. “Just to say that an arbitrary three-year mark for someone like Ryah, that doesn’t seem appropriate to me.”

ABA therapy is behavior based, helping individuals with autism improve communication, socialization and development.

When the FSSA first proposed cuts to ABA coverage, Tiede said she reached out to her local lawmakers, State Rep. Hunter Smith, R-Zionsville and State Sen. James Buck, R-Tipton Co.

She said she felt ignored when neither responded.

“I was really hoping that a dialogue could be created and it was pretty disappointing,” Tiede said.

The Autism Society of Indiana held an advocacy day at the statehouse Monday, Feb. 17, so people could directly share their stories with lawmakers face to face.

“We feel a lot of lawmakers don’t even know what autism is,” ASI Dir. of Training and Legislation Rachel Deaton said. “If a lawmaker understands what a parent is going through, from the time they wake up to the time they go to bed and how much ABA is helping them, they might be willing to advocate for it.”

Indiana is trying to get ABA spending under control after an audit found the state made at least $56.5 million in improper Medicaid payments for ABA services over the course of a year.

The ABA cuts also come as the Braun Administration initiates a larger Medicaid crackdown by increasing eligibility checks, supporting legislation to add work requirements and enrollment caps and ordering providers to stop advertising Medicaid programs.

John Lotz, whose son Drake went through ABA, believes these changes are focused on regulating the parents rather than providers.

“Our children are discriminated against every day,” Lotz, an advocacy leader with Indiana Profound Autism Alliance, said.

He wants the FSSA to avoid implementing the three-year cap and instead base coverage on need. He also doesn’t think it will do much to curb improper billing.

“You’re really not going to hurt the ABA centers because they’re just going to re-adjust their business model to bring in more kids for fewer hours,” Lotz said. “The ones that are going to be pushed out are the ones with the greatest needs.”