By State Sen. Jon Ford (R-Terre Haute)
As a state senator, I often find myself analyzing issues through the perspectives of different interest groups to make informed and educated decisions. Throughout my tenure, I have found our most vulnerable Hoosiers have the most valuable perspectives. Recently, I learned of the Indiana Family and Social Services Administration’s (FSSA) proposed change to rates for Applied Behavior Analysis (ABA) therapy services, and I am concerned about the possible impacts this rate could have on Hoosiers who desperately rely on these services.
Indiana has a long history of supporting Hoosiers with autism. In 2001, the Indiana General Assembly codified a mandate to provide certain insurance coverage for individuals needing autism services, like ABA therapy. In 2016, Indiana's Medicaid program began covering ABA therapy, further ensuring eligible Hoosiers' access to these services.
Currently, Medicaid reimburses ABA therapy providers at a set percentage of charges billed for rendering services. According to FSSA’s recently published findings, this billing system, among other factors, has contributed to an increase in state spending for ABA services from $121 million in 2019 to $420 million in 2023. With costs projected to continue compounding, absent a change in the reimbursement model, FSSA has recommended instituting a set fee of $55.16 per hour for ABA therapy services provided by a Registered Behavioral Technician (RBT).
While I understand and support FSSA’s efforts to stabilize costs through a transition to a fee-for-service reimbursement model, I am concerned the current rates do not reflect the true cost of providing these services in today’s economy. Claims data show providers currently receive an average reimbursement of approximately $91 per hour, which is nowhere near FSSA’s proposed rate. Additionally, I have heard from several service providers who have indicated that inflationary impacts from the COVID-19 pandemic, namely increased wages, continue to keep the cost of doing business higher than ever before.
I sympathize with the viewpoints of all those involved in this conversation, understanding both the need to ensure accessible and affordable services for Hoosiers with autism and the need to stabilize spending. However, ensuring those in need of services continue to have access to them remains my top priority. As I continue to work on this issue with my colleagues, I will advocate for a higher fee-for-service rate than what has been proposed by FSSA to achieve a sustainable and fair result for service consumers, service providers and the state.
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State Sen. Jon Ford (R-Terre Haute) represents Senate District 38, which
includes Vigo and Clay counties and a portion of Sullivan county.
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