Shackleford demands immediate pause on Medicaid waiver denials following sharp spike in care cuts for Hoosiers with special needs
In response to recent investigative reporting by WTHR revealing that nearly 2,500 Hoosiers with intellectual and physical disabilities face devastating cuts or denials to their Medicaid waiver services under a new state assessment process, State Rep. Robin Shackleford (D-Indianapolis) called on the Family and Social Services Administration (FSSA) to take three steps, including immediately halting waiver denials:
Pause All Waiver Denials & Service Reductions: Put an immediate moratorium on adverse determinations, waiver revocations, and care reductions.
Audit the New Assessment Tools: Conduct an independent review of the new assessment forms and scoring criteria to determine how and why so many eligible Hoosiers are being mischaracterized as no longer needing support.
Ensure Full Appeal Transparency: Automatically provide families with complete, unredacted copies of their assessment evaluations, case manager notes, and scoring rubrics immediately upon request so they have a fair opportunity to appeal.
Shackleford released the following statement:
"The stories highlighted in WTHR's report are heartbreaking, unacceptable and represent a profound failure to protect our state's most vulnerable citizens. Hoosier families who rely on Medicaid waivers to keep their loved ones safe, supported, and living in their communities are being blindsided by arbitrary administrative cuts.
"Historical Medicaid waiver denial rates in Indiana sat near 1%. Following the rollout of FSSA's new assessment tools earlier this year, denial rates have skyrocketed to between 5% and 16%, leaving more than 700 children and adults already denied and over 1,700 under review. It is impossible to look at these numbers and conclude anything other than that the state is using rigid, flawed assessment tools as a sledgehammer to make up for FSSA's budget shortfalls at the expense of Hoosier families.
"A three-day lookback window, binary yes-or-no questions, and opaque scoring algorithms cannot replace the reality of what a person with complex needs experiences every single day. Furthermore, forcing families to beg for basic documentation of their own child's assessment just to navigate an intimidating appeals process violates fundamental principles of fairness and transparency.
"Care for Hoosiers with special needs is not a political bargaining chip, nor is it line-item overhead to be trimmed. We must immediately pause these denials, fix these broken assessment tools, and ensure every Hoosier with special needs gets the care and dignity they deserve."