If your family uses one of Indiana's Medicaid waivers, the pool of providers you can hire is about to stop growing. The state received federal approval to halt certification and enrollment of new home and community-based services providers across all five of its 1915(c) waivers: Indiana PathWays for Aging, Health and Wellness, Traumatic Brain Injury, Community Integration and Habilitation, and Family Supports. The freeze starts August 1, 2026, runs for an initial six months, and can be extended in six-month increments after that.

The moratorium doesn't touch your current services. If your provider is already enrolled, nothing changes on Saturday. What changes is what happens when you need someone new.

Why Indiana Is Doing This

The state says it found roughly $200 million in improper payments to attendant care providers, with problems that included missing background checks and incomplete service plans. Family and Social Services Administration Secretary Mitch Roob ordered the freeze, and Kelly Mitchell, who directs the Division of Disability, Aging, and Rehabilitative Services, described it as "part of our efforts to eliminate fraud, waste, and abuse." Federal rules at 42 CFR 455.470 let a state pause new provider enrollment when it identifies a significant risk of fraud.

Indiana has run this play before on a smaller scale. A separate moratorium on new ABA therapy group enrollments took effect June 6. Other states are working the same terrain: Minnesota's audit-driven purge cut off 61% of its Medicaid disability providers before reinstating many of them, and the broader Medicaid fraud crackdown has already forced families in several states to find new providers on short notice.

The state also plans to audit and review the roughly 3,000 provider agencies already operating. A freeze on new enrollments combined with audits of existing ones can shrink the provider pool from both ends.

What the Freeze Covers, and What It Doesn't

Twenty-four waiver services fall under the moratorium, including attendant care, day habilitation, respite care, and transportation. Nineteen services are exempt, among them case management, occupational therapy, and supported employment. So a new OT practice can still enroll this fall; a new attendant care agency cannot.

Pending applications get sorted into different lanes depending on the waiver. For Health and Wellness, PathWays, and TBI providers, applications already under review will be processed, while new applications and those still waiting for review will be expired. For CIH and Family Supports, pending applications will be expired, and applications that reached provisional approval will be held until the moratorium ends. A provider who wants to serve families during the freeze needs every screening requirement completed before August 1.

There is an exception process for access problems. The state can grant limited exceptions when a family can't reach a needed service, and requests go to OMPPProviderRelations@fssa.in.gov with a written explanation of the access concern. If the only attendant care agency serving your county has a frozen application, that inbox is where the problem gets raised.

The Freeze Lands on Top of the August 1 Waiver Changes

The same date carries a package of amendments to the CIH, Family Supports, Health and Wellness, and TBI waivers that the state has approved and slated for August, pending final federal sign-off. Those amendments reduce the reimbursement rate for live-in caregivers and cap paid caregiving by legally responsible individuals, meaning parents of minor children and spouses, at 40 hours per week combined. Case management consolidates to five organizations on August 1 as well. If the caregiver pay rules affect your household, there's also a national legal fight over whether parents of minor disabled children can be paid as Medicaid caregivers at all, and its outcome would reach Indiana households directly.

Kim Dodson, who leads The Arc of Indiana, points out the tension families already know: the state has around 3,000 provider agencies but a persistent shortage of the individual workers who show up in living rooms. The freeze doesn't create that shortage. It does mean the supply of new agencies stays flat for at least six months while demand doesn't.

What to Do Before Saturday

Start with a status check on your own provider. Ask whether their IHCP enrollment and waiver certification are fully complete, not just submitted. An agency that assumed it could finish paperwork in August now has a hard deadline of July 31, and a family relying on that agency should know which side of the line it lands on.

If you were planning to switch providers or add a new one, ask every agency on your list where its certification stands. An agency with a pending CIH or Family Supports application will not be an option until at least February 2027, and possibly longer.

Families in thin-coverage areas should document access problems as they happen: the agencies called, the waitlists quoted, the counties with no willing provider. That record is exactly what an exception request needs, and it strengthens any complaint to your case manager or to The Arc of Indiana, which tracks waiver changes and takes reports from families.

Ask your case manager for a current copy of your service plan and authorization levels this week. With audits of existing providers coming, the families who hold their own paperwork are the ones who can prove what they were receiving if a provider suddenly exits. Six months is a long time to hold your breath in a system this tight, but it's enough time to confirm your providers are solid, line up alternatives that are already enrolled, and get your documentation in order.