Indiana's Family and Social Services Administration told reporters on Oct. 2 that it will lift an Aug. 31 pause on interRAI ICF/IID level-of-care determinations on Monday, Oct. 5, according to a statement published by WRTV.
FSSA said the pause covered assessments awaiting Bureau of Disabilities Services review and was meant to make sure supports coordinators (case managers) ran the process consistently. The agency said the issue was how assessments were administered, not a flaw in the InterRAI tool, and that it remains confident in InterRAI for evaluating needs.
The pause followed complaints that a new assessment process used for Medicaid waiver eligibility was producing more denials for home- and community-based care. Indiana Public Media reported Sept. 25 that Bureau of Disability Services Director Holly Wimsatt announced the pause at a Medicaid Advisory Committee meeting so staff could review trends, strengthen quality assurance and training, and review pending determinations.
Arc seeks transparency on eligibility logic
The Arc of Indiana said Oct. 1 it supports pausing adverse determinations and corrective action, but filed an Access to Public Records Act request for how InterRAI answers are mapped to Indiana's level-of-care rules. CEO Kim Dodson said FSSA told the Arc that people with adverse determinations already in appeal would see those determinations retracted and receive new assessments, with specially trained assessors and the assigned case manager involved.
Why this matters for providers and DSPs
For Indiana provider agency teams and DSPs, Oct. 5 restarts eligibility decisions that decide whether people keep HCBS hours. Watch for retracted denials, mentor-led reassessments, and clearer documentation requests as BDS reviews how assessments were done.