Indiana accelerates reforms after Medicaid spending surge

INDIANAPOLIS, IND. (WOWO) Indiana officials are stepping up enforcement on autism therapy providers amid growing concerns about billing practices within the state’s Medicaid program.

Providers offering applied behavior analysis, or ABA therapy, are now being required to self-report any activity that could be considered fraud, waste, or abuse by an early April deadline, according to the Indiana Capital Chronicle. The directive follows heightened scrutiny over the cost of services and how some providers billed the state in recent years.

ABA therapy is commonly used to help children with autism develop communication and learning skills. Its use has expanded significantly, with thousands of Hoosiers relying on Medicaid coverage for treatment.

State data shows spending on the therapy surged dramatically over the past several years, reaching hundreds of millions of dollars annually. Investigations highlighted unusually high billing levels in some cases, including one provider receiving tens of millions of dollars to treat fewer than 100 patients.

In response, the Indiana Family and Social Services Administration says it is accelerating reforms aimed at tightening oversight. Those changes include stricter provider requirements, new limits on services, and updated reimbursement structures.

State officials say the goal is to curb improper billing while maintaining access to care. However, some advocates caution that aggressive reforms could have unintended consequences for families who depend on the therapy.

The situation has drawn national attention and raised broader questions about how Medicaid programs monitor costs and ensure accountability, while still supporting critical services for vulnerable populations.

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