Indiana updates BDS complaint reviews

Indiana’s Bureau of Disabilities Services (BDS) has issued a revised complaints policy that changes how complaints involving Medicaid and state-line funded providers are reviewed and enforced. The updated approach becomes effective January 16, 2026. The revision centers on a more structured process for complaint investigations and sets clearer expectations for provider cooperation and documentation availability during reviews.

Effective date and policy focus

The revised policy applies to complaints against Medicaid and state-line funded providers under BDS oversight. BDS states the policy reflects a shift in how complaint reviews will be conducted, with a formalized investigative framework and clearer definitions around what information can be used to support findings. The updated complaints policy is identified as Policy BDS 460 0221 005 and is scheduled to take effect on January 16, 2026.

Investigation process and documentation requests

Under Policy BDS 460 0221 005, BDS has formalized its investigative process and expanded the types of documentation that may be requested during complaint reviews. In addition to records commonly associated with service delivery and oversight, BDS may now request:

• EVV visit records

• Billing claims data

• Service plans

• Incident reports

• Behavior documentation

• Related records

The policy positions EVV and claims data as documentation that can be reviewed as part of an investigation, alongside other provider records. This change places increased operational importance on documentation that aligns service activity with billing and visit verification, as those materials may be treated as direct evidence sources during complaint investigations.

Provider timelines, complaint classification, and enforcement

The revised policy establishes expectations that providers respond within defined timelines and fully cooperate with all documentation requests. BDS notes that failure to comply can result in civil sanctions, service moratoria, or termination as a BDS provider. The policy also categorizes complaints by urgency, with different timelines tied to the complaint level. Urgent complaints typically require written investigation summaries within 30 business days, while critical complaints may allow up to 45 business days.

BDS describes the overall update as a move toward more structured enforcement. The revised framework increases the emphasis on documentation accuracy, accessibility, and audit readiness, given the expanded scope of materials that may be requested and reviewed during complaint investigations.