FSSA Restarts Medicaid-Waiver Denials Monday — Arc's Records Request Still Blank

Indiana Government Center North, Indianapolis. Photo by IndyTaylor / Wikimedia Commons, CC BY-SA 4.0.

Indiana Government Center North, Indianapolis. Photo by IndyTaylor / Wikimedia Commons, CC BY-SA 4.0.

Monday's calendar is already set. The black box is not.

Indiana's Family and Social Services Administration says its pause on adverse interRAI ICF/IID level-of-care determinations — the decisions that can strip disabled Hoosiers of home- and community-based Medicaid waiver services — ends Monday, Oct. 5. In an Oct. 2 statement carried by WRTV, the agency said the halt that began Aug. 31 was about case-manager consistency, "not due to any issues with the interRAI tool itself," and that "We remain fully confident in the interRAI tool."

What FSSA has not published with that confidence is the other half of the machine: how InterRAI answers get mapped into Indiana's own yes-or-no eligibility call, how many adverse decisions the new process produced before the pause, or the documents Arc of Indiana sought under the Access to Public Records Act. Denials restart on a Monday clock. The mapped criteria stay sealed.

What the pause was — and was not

FSSA's Oct. 2 statement framed the stop as a quality-control hold for assessments awaiting Bureau of Disabilities Services review, so case managers would administer the tool "consistently and in line with state standards." The agency blamed "variability in how assessments were being administered," not the instrument.

That announcement followed weeks of pressure. At the Sept. 21 Medicaid Advisory Committee meeting, Bureau of Disability Services Director Holly Wimsatt said the pause would give the bureau time "to further assess trends, enhance quality assurance procedures, and enhance our training approach," and that BDS staff would review pending determinations for potential reassessment, Indiana Public Media / WFIU reported Sept. 25. State Rep. Robin Shackleford (D-Indianapolis) told the same outlet she had heard from case managers who felt rushed and undertrained after the new tool rolled out — some saying training lagged while they were still expected to clear assessment lists.

Arc of Indiana, the statewide disability-rights nonprofit, said Oct. 1 it supports the pause and corrective action. CEO Kim Dodson and chief legal officer Tom Crishon are pressing for something FSSA's confidence statement does not supply: transparency on how assessment data becomes an eligibility decision.

The records Arc already filed

Crishon told WRTV the network needs to see "not just how the information gets into the assessment, but how that information comes out the other side as a 'yes' and 'no' eligibility decision." Arc's Oct. 1 release says InterRAI itself does not decide who qualifies for Indiana's Medicaid waivers — Indiana does — because FSSA mapped InterRAI fields onto the state's level-of-care criteria. The public-records request seeks that methodology, plus training, quality-assurance, implementation-problem, and outcome records.

Dodson said FSSA told Arc that individuals with adverse determinations already in the appeal process will have those determinations retracted and receive new assessments, and that other people flagged for assessment problems will be reassessed by mentors or specially trained assessors with the assigned case manager present. Arc backs that approach. It still wants the mapping that turns InterRAI data into a state yes or no.

What Monday restarts without showing

FSSA's public line is that Monday's lift follows retraining and consistency work, and that the tool itself is sound. The public ledger still missing from that line includes statewide denial counts under the new process, the published mapping of InterRAI fields to Indiana criteria, and any release of the records Arc filed for. Separately, Healthy Indiana Plan work requirements for many adults begin Jan. 1, 2027 — a different FSSA clock, not this waiver fight.

On Monday, the pause ends. Families facing a new adverse level-of-care decision will meet a restarted process before they meet a published map of how Indiana turns InterRAI answers into yes and no.

Sources: WRTV I-Team, Oct. 1–2, 2026; Arc of Indiana, Oct. 1, 2026; Indiana Public Media / WFIU, Sept. 25, 2026; WTHR coverage of the Monday lift. Photo: Wikimedia Commons.

Written by Hoosiers, for Hoosiers.