INDIANAPOLIS (WISH) — Indiana’s Medicaid director on Tuesday said measures were in place to prevent future budget shortfalls but could not name the exact factors that led to the last one.

Testifying before the state Medicaid Oversight Committee for the first time since the end of the legislative session this spring, Indiana Medicaid Director Cora Steinmetz said the Family and Social Services Administration has implemented several cost-saving measures to make up its funding gap for the rest of the current budget cycle. Chief among them was the decision to discontinue parents’ eligibility for reimbursement under the attendant care program, which pays caregivers for the costs of caring for someone who is unable to perform basic daily functions.

Until July 1, parents could be designated legally responsible individuals and get reimbursed at a rate of $36.34 per hour under the attendant care program. Steinmetz told the committee a rapid increase in program users caused the program’s costs to triple from $557 million during the 2023 budget year to $1.4 billion during the 2024 budget year. She said about 1,600 children and their families were using the program.

About 70% were shifted over to structured family caregiving, which is nearly identical but provides a daily reimbursement rather than an hourly one. Steinmetz said nearly all of those families qualified for the highest level of reimbursement under structured family caregiving, about $133 per day. Another 22% remained on the legally responsible individual program but now have someone other than their parents providing most of the care. The rest switched to different programs.

Steinmetz said the FSSA has begun monthly expenditure reviews so officials can catch any cost overruns early and avoid drastic reductions in service. Rep. Greg Porter, D-Indianapolis, twice pressed FSSA officials on Tuesday to explain the specific factors that led to the December 2023 revelation that the Medicaid fund would face a nearly $1 billion funding shortfall. Officials including Steinmetz would not say, instead referring back to the measures they are putting in place.

Rep. Hal Slager, R-Schererville, said he thinks the more frequent financial reporting will prevent future funding crises.

“It’s going to give us a heads-up early on so if we see something out of line, we’re going to know it much sooner than if we wait until the next Medicaid forecast and get surprised by it,” he said.

Porter wasn’t so sure. He said the funding issue won’t truly be solved until lawmakers know exactly what led to the shortfall in the first place.

“Until we realize what were all the factors that drove up those costs, until they fully disclose that, and they’re still not disclosing how we got to that point,” he said, “it still isn’t there.”