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Public Response Statement From the Autism Society of Indiana

Regarding the ABA Work Group Recommendations

The Autism Society of Indiana understands that many families are feeling overwhelmed, fearful, and uncertain after the release of the ABA Work Group recommendations. Any change to services that families rely on—especially services as significant as ABA—creates real emotional strain. Parents have expressed deep concerns about access, long-term support, and what these changes may mean for their children’s futures. We want families to know that your emotions and your experiences matter, and they are at the heart of our response.

Indiana is facing a difficult challenge. Medicaid spending on ABA has risen from $21 million in 2017 to $611 million in 2023, and the state is seeking ways to curb costs to ensure long-term sustainability. The ABA Work Group was tasked with finding strategies that contain spending while attempting to minimize the negative impact on children and families. The Autism Society of Indiana participated in this process with the understanding that while these recommendations are not ideal, failing to address statewide costs could ultimately result in more severe reductions in access.

The Work Group produced a broad package of recommendations, including:

  • A lifetime guidance of up to 4,000 hours of comprehensive ABA (with eligibility for continued targeted ABA afterward), tracked through an updated prior authorization process.
  • Requiring 12–18 hours of caregiver coaching per authorization period.
  • Establishing guidance for appropriate use of group therapy hours.
  • Setting standardized BCBA-to-RBT supervision ratios.
  • Requiring state-determined accreditation for provider agencies.
  • Implementing a temporary moratorium on new ABA clinic sites.
  • Minimizing additional barriers for RBTs to participate in Medicaid networks.
  • Establishing fair and predictable reimbursement rates, including potential quality incentives.
  • Creating an ABA Program Office within FSSA to oversee quality and utilization management.

We recognize that these recommendations may feel restrictive to families and may impact access to services that children need. We also recognize that the proposals aim to improve quality, address inconsistencies, and ensure the long-term viability of Medicaid-funded services in Indiana. The Autism Society of Indiana will continue to carefully examine each recommendation, its potential impact, and its alignment with evidence-based, individualized care.

Our Commitment to Families

Throughout this process and beyond, our priority is you—the families who depend on a coordinated system of supports. We will continue to:

  • Advocate for access to high-quality services, including ABA and a full range of evidence-based supports (OT, speech, developmental therapies, and inclusive education).
  • Center lived experience stories of autistic individuals and their caregivers, ensuring state decision-makers understand the realities families face.
  • Push for thoughtful implementation, including transition protections, clear communication, and flexibility for unique family circumstances.
  • Support families directly as they navigate any changes, offering guidance, resources, and advocacy assistance.

These recommendations represent a significant moment for autism services in Indiana. While they are intended to safeguard Medicaid sustainability, we know they will raise questions, fears, and frustrations. Please know that the Autism Society of Indiana is here with you, listening closely, and working continuously to protect access, dignity, and opportunity for every Hoosier on the autism spectrum.

Families with questions or concerns are encouraged to contact us directly. We stand with you, and we will continue to ensure your voices remain central in every conversation about your child’s care.