Indiana Resumed Medicaid Waiver Eligibility Determinations
Hoosier families with pending disability waiver applications should expect new assessment notices following a program review.
Updated on Oct. 6, 2026 in Special Needs
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The Indiana Family and Social Services Administration has resumed level-of-care determinations for disability Medicaid waivers after a month-long pause. The agency is now rescinding previous denials to trigger new assessments for affected families.
Why it matters
Officials paused the process in August to address concerns about the consistency of assessments conducted under the new interRAI algorithm. This shift aims to ensure accuracy after internal reviews suggested an approval rate of approximately 90%.
The agency is rescinding current denials currently in appeals for mandatory reassessment. This covers determinations made between the adoption of the interRAI algorithm in January 2026 and the program pause.
The players
Indiana Family and Social Services Administration
The state agency responsible for overseeing and administering Medicaid waiver programs for Hoosiers.
The Arc of Indiana
A statewide advocacy organization focused on supporting people with intellectual and developmental disabilities.
The details
Case managers use the interRAI algorithm to evaluate eligibility for disability waivers. To improve consistency, the new assessment process now requires specially trained assessors and mentors to work directly alongside the assigned case managers for each evaluation.
Timeline
January 2026: Case managers began using the interRAI algorithm.
August 31, 2026: FSSA paused level-of-care determinations.
September 30, 2026: The Arc of Indiana filed a records request.
October 5, 2026: Determinations resumed.
The Home Front
This decision updates the state's rollout of the interRAI assessment framework for disability services. It reflects a broader effort to align state-level administrative procedures with anticipated program approval benchmarks.
If you had a pending denial or were in the appeals process, keep a close watch on your mail for instructions regarding a new assessment. You should prepare to work with your case manager and the assigned specialist to schedule the updated evaluation.
The takeaway
The state is now actively reversing prior denials to ensure a more consistent assessment experience for families. Keep your case documentation organized and reachable so you are ready when your family is contacted for a re-evaluation.
Further reading
Families can find more resources on navigating support services in our Special Needs section.
Live Poll
Do you trust your state government to implement new eligibility tools fairly for disability services?
