Indiana Medicaid Waiver Reset Audit: Tracking the $1 Billion Transparency Gap
Since January 2026, the Indiana Family and Social Services Administration (FSSA) has entered a state of strategic administrative silence, freezing all public financial reporting while implementing the most aggressive ‘Waiver Reset’ in state history. While the administration publicly cites a multi-billion dollar Medicaid shortfall to justify service caps—including the controversial 4,000-hour lifetime limit on Applied Behavior Analysis (ABA)—internal metrics and federal reporting tell a different story. This audit documents a systematic data blackout: from the deliberate suppression of the April 2026 enrollment numbers to the 404-error obstruction of the Medicaid Fair Hearing portal. IndianaMedicaidHelp.org exists to bridge this transparency gap, surfacing the forensic data that proves Hoosier families are being ‘churned’ off the rolls not by lack of need, but by engineered administrative friction
Facts:
The April Gap: Enrollment data for April 2026—the first month of the “Waiver Reset” caps—remains withheld from the public.
Due Process Obstruction: The primary OALP/FSSA portal for appeal instructions (in.gov/fssa/1032.html) is currently generating a 404 error, coinciding with a self-reported “scanning backlog” for physical appeals.
Federal FOIA Request #2909696 has been filed with CMS (Federal Medicaid) to retrieve the T-MSIS and CMS-64 datasets that the State of Indiana has failed to publish. The State of Indiana is not publishing this data on their own websites, but since they receive federal dollars, we are going to track down the actual numbers from the Federal Department of Medicaid Services
We have asked the FSSA of Indiana public communications director if they would like to comment, as of this posting the state of Indiana has not responded on record.
Case Management Organizations Changes
The forced exit of CareStar and other long-standing Case Management Organizations (CMOs) marks the beginning of the ‘selective contracting’ phase of the Waiver Reset. By August 1, 2026, the state is effectively narrowing the field from dozens of local vendors to just five state-approved entities (The ‘Big 5’). While FSSA frames this as a simplification of the system, the reality is a massive consolidation of power. By limiting the number of vendors, the state gains the ability to enforce uniform service caps—like the 4,000-hour ABA limit—with far less institutional resistance. For families, this transition is a high-risk churn event: if you do not select a new agency by July 15, 2026, you will be auto-assigned. In a system already plagued by a ‘scanning backlog’ and 404-error portals, these forced transitions are designed to move families into a more restrictive, state-controlled environment where sustainability takes precedence over individual care. Every time a family is forced to switch case managers, paperwork is lost, authorizations expire, and the clock restarts on appeals. This “administrative friction” naturally reduces the state’s expenditures by simply making it harder for beneficiaries to stay enrolled.
