Indiana Resumed Medicaid Waiver Determinations

The state restarted disability waiver evaluations after pausing the process to review assessment accuracy.

Updated on Oct. 6, 2026 in Special Needs

Isometric editorial illustration showing balanced analytical steel scales, representing a fair and structured administrative eligibility process. — The Indiana Family and Social Services Administration has resumed disability waiver eligibility determinations following a mandatory review of assessment accuracy. AI Illustration. Upload story photo >

Live Poll

Do you trust your state government to implement new eligibility tools fairly for disability services?

The Indiana Family and Social Services Administration (FSSA) resumed level-of-care determinations for Medicaid waivers on October 5, 2026. This restart follows a pause initiated in August to address concerns regarding the implementation of a new assessment algorithm.

Why it matters

Officials paused the process to ensure consistency among case managers after internal data suggested the program should have an approval rate closer to 90%. The agency is now reassessing individuals who were previously denied under the initial implementation.

The FSSA adopted the interRAI algorithm in January 2026 to determine eligibility for disability Medicaid waivers. Following the pause on August 31, 2026, the state is now utilizing mentors and trained assessors to oversee evaluations.

The players

Indiana Family and Social Services Administration

This state agency is responsible for managing Medicaid waiver programs and disability service eligibility.

The Arc of Indiana

This organization advocates for people with intellectual and developmental disabilities and requested records regarding the waiver process.

The details

The agency began rescinding denials currently under appeal to perform mandatory new assessments. These evaluations involve mentors and trained assessors working alongside case managers to verify eligibility under the interRAI system.

January 2026: Case managers began using the interRAI algorithm for assessments.
August 31, 2026: The FSSA officially paused all level-of-care determinations.
September 30, 2026: The Arc of Indiana filed a formal records request regarding the process.
October 5, 2026: The agency resumed the determination process for disability waivers.

Culture Shift

This restart reflects a wider movement toward rigorous oversight in digital-first state eligibility systems, such as the Indiana Medicaid HCBS Waiver program. The move attempts to balance automated algorithm efficiency with the need for human verification in sensitive healthcare services.

Residents who previously received denials should expect notification regarding the mandatory reassessment process. Those currently in the appeals process may see their status updated as the state moves to rescind previous denials for review.

The takeaway

The state is prioritizing human oversight by pairing mentors with case managers to ensure accurate disability evaluations. Individuals affected by the previous pause should monitor their communications from the FSSA for specific instructions on their reassessment.