At least $56 million in incorrect Indiana Medicaid payments are discovered during an audit

Indianapolis, Indiana – Following a federal audit that found the state had improperly paid at least $56 million in Medicaid to Hoosiers with autism, Indiana leaders are demanding “urgent” adjustments.

Under the heading “Indiana Made at Least $56 Million in Improper Fee-for-Service Medicaid Payments,” the U.S. Office of the Inspector General recently released an audit. According to the 45-page analysis, a large number of Indiana’s Applied Behavioral Analysis (ABA) payments during the previous few years did not adhere to federal or state regulations.

Indiana’s Medicaid spending on ABA therapy reportedly increased from $14 million to $102 million between 2017 and 2020, making it the state with the second-highest rate in the nation.
Investigators claim that an additional $76.7 million was utilized for “potentially improper” payments, notwithstanding the report’s conclusion that $56.5 million of Medicaid funds were wasted on unlawful payments. According to auditors, the federal government contributed $39.4 million, a significant portion of these payments.

According to the audit, families of autistic children were receiving these reimbursements for ABA therapy. Nevertheless, it appeared that the payments were being made without scrutiny, costing the government millions of dollars.

The audit identifies a number of noteworthy problems with the payments being made, such as:

• Incomplete documentation,
• Lack of evidence for services provided,
• Billing for non-therapy time,
• Uncredentialed providers, and
• Services without proper referrals.

Shelli Yoder (D-Bloomington), the recently chosen minority leader of the Indiana Senate, is now demanding immediate reforms.

Indiana leaders must be held responsible and make sure vital resources are being spent appropriately, according to Yoder, a newly appointed ranking minority member of the Health and Provider Services Committee.

Families who depend on these services bear the brunt of unregulated Medicaid payments, according to Yoder. “Every dollar that is wasted is a missed chance to provide the care that children in Indiana need.”

The results are a wake-up call for the State’s healthcare system, Yoder continued.

She stated, “This is about more than dollars and cents.” The goal is to develop a system that benefits the families for whom it was intended. We must let oversight flaws endanger the safety of our most vulnerable citizens.

In a statement on Friday, Yoder said she is now urging the FSSA to take immediate action to recoup erroneous payments, enhance training, and guarantee accountability that payments are legitimate.

According to the Inspector General’s audit, Indiana is currently being asked by the federal government to return $39.4 million and implement major reforms to enhance Medicaid documentation of ABA services.

Cora Steinmetz, the director of Indiana Medicaid, announced her resignation in early 2025 shortly after the report was released. Since August 2023, Steinmetz has held the role.