ICYMI: Separating Fact from Fiction on Proposed Cuts to Autism Services

Hoosier families across Indiana are continuing to urge Governor Holcomb to reconsider the FSSA’s proposed cuts to autism services following the release of their public appeal asking the Governor to set a higher reimbursement rate to avoid the loss of essential, life altering care for thousands of children receiving autism services.

Moms Take to Airwaves

On Friday, Indianapolis TV station, FOX59, visited Shine Pediatric Therapy, run by coalition member, Courtney Hodge, to speak with families, including Ausome Indy nonprofit founder, parent and coalition member, Kate Miller, about the impact of the proposed cut to the Medicaid reimbursement rate for ABA therapy by nearly 50 percent. A mom interviewed by FOX59  called ABA therapy a “blessing” for her family and credits Shine with helping her son become more independent.

On Monday, South Bend TV station, WSBT, visited Lighthouse Autism Center, a coalition member, to interview Leila Allen, their Chief Clinical and Compliance Officer. In response to the proposed cuts, Leila said that “ABA providers simply can’t necessarily keep their doors open” and “future kiddos … might not even have an opportunity to get into services like this.”

Rep. Greene, the Parent of a Child with Autism Expresses Concern

Speaking to Indianapolis TV station, WTHR, Indiana Representative Robb Greene spoke about the first-hand impact of ABA therapy had on his own child with autism. Greene urged state officials to “slow this process down to work with providers to find a reimbursement rate that works for all.”

Facts

Let’s be clear: Since the release of families’ public appeal there have been statements made by certain stakeholders that seek to misconstrue the message coming from Hoosier moms, and this coalition.

• Costs: FOX59 story highlights FSSA’s position that in 2022 Medicaid ABA therapy expenses were $420 million and “over the last 3 years, ABA expenses increased by more than 50% each year.”
  
  There is no denying that Medicaid reimbursement costs – which are largely borne by the Federal government, not the state – have increased over time, but this fails to address the clear and obvious impact of the FSSA’s proposal: Centers will close and reduced access to ABA therapy for Hoosier children, the most vulnerable population, will become a grim reality.
  
  In truth, the growth in Medicaid spend can largely be attributed to an increase in the prevalence of autism among the general population, growth in access to diagnosis options, and an increase in the number of children receiving services, – largely because they have greater access to center based care – all of which are positives for Indiana and children with autism (per CDC about 1 in 36 children had been diagnosed with autism by age 8 in 2020 which is up from 1 in 44 children in 2018).

• Closures: It is not accurate and incongruent with providers’ own reports to assert that there will not be closures and other reductions in access to care. Providers have been clear that the significant rate cuts threaten their ability to provide services to families on Medicaid. These fears are not unfounded – providers have shut down in states like Colorado and Oregon due to Medicaid reimbursement rates that weren’t financially sustainable.

• Support for a Fixed Rate and “Standards”: Providers, including coalition members, have stated in clear, unambiguous terms support for a fixed uniform rate fee schedule across all providers, which would address Medicaid spending and budget concerns without threatening families’ access to autism services.
  
  Unfortunately, providers’ support for a fixed rate appears to be ignored by officials who favor more extreme cuts. Governor Holcomb, during his interview with WTHR spoke about how his administration’s proposal will bring about “standards,” which are “long overdue.” These comments are similar to canned responses being sent to parents by legislators that state the “perception of “cuts” to the reimbursement rates for ABA therapy…” is really only about “working to standardize and establish consistent reimbursement rates for ABA services.”
  
  However, the fact is that FSSA’s proposed reimbursement rate for ABA therapy is nearly 50% lower than the current average reimbursement for the most common form of ABA therapy and significantly below provider costs to deliver therapy. There is no way around the truth: This is not standardization, this is a significant cut to autism services.

The Holcomb Administration’s proposed reimbursement cut will have disastrous consequences for children with autism and Hoosier families on Medicaid.

Governor Holcomb, you are our last hope, and we urge you to reconsider these cuts and to support financially sustainable rate that protects kids’ access to autism services and keeps ABA therapy centers open.