Inside the June Collapse of Stepping Stones Behavioral Solutions

INDIANAPOLIS – Stepping Stones Behavioral Solutions closed on June 12 with a day’s notice to its managers, staff, and families, according to Inc., ending an autism-therapy business that had made the magazine’s list of America’s fastest-growing private companies four years running. Nearly four months later, the public record, the founder’s published interviews, and Indiana’s own policy bulletins show a company that had been losing ground for more than a year before the end. (The company is unrelated to The Stepping Stones Group, a Colorado-based school-staffing and therapy business.)

The clearest sign is in federal claims data. Medicaid paid the company $16.6 million in 2023 and $4.7 million in 2024, a drop of roughly 70% in a year when its claim-line count barely moved, according to federal Medicaid payment data compiled by the search site medicaidspending.org. The figures reflect payments to the only one of the company’s seven provider numbers that appears in the dataset, and the 2024 total is preliminary and runs only through November, so the decline is probably a few points smaller; in matched months, it is 69%. The drop coincided with Indiana’s switch, on Jan. 1, 2024, from paying ABA providers a percentage of whatever they charged to a standardized fee schedule.

Founder and CEO Veronica Napier has given her own account. She told Inc. in September that the company’s difficulties became acute in the fall of 2025, that Indiana Medicaid froze its payments during a fraud review that ended in February with no action, and that Anthem, one of the three plans serving Hoosier Healthwise, the state’s Medicaid program for most children, told the company in April that it would be removed from the plan’s network. Both events, she said, hit a business already under “significant financial pressure.”

Neither the state nor Anthem has publicly addressed her account. The publicly available sources BreakingNewsABA reviewed include no state determination or Anthem notice confirming either action or its reasons; a suspension notice goes to the provider and is not routinely published. What the record does show, from state filings to federal claims data to Napier’s own 2024 interviews, is a company whose recorded Medicaid payments rose from less than $400,000 in 2019, a partial year in the dataset, to $16.6 million in 2023, and then fell by more than two-thirds a year and a half before it closed.

From a Muncie Salon to 10 Clinics

Napier’s version of the beginning appeared in Inc. in August 2024, when the magazine ranked Stepping Stones No. 468 on its annual list with 957% three-year growth. She said she was running a hair salon in Muncie, Indiana, when she enrolled in an online psychology program in 2014. A friend who was a BCBA suggested she try working at an autism center, and she switched her specialization to applied behavior analysis. She wanted “to open my own center for people with autism, one that would accept Medicaid,” she said, to serve “the mostly Black and Brown kids who were going to these facilities.”

She founded the company in 2016, rented a single room in Indianapolis in 2017, and hired a few behavior therapists. Within six months, by her account, she had seven children enrolled and four on a waiting list. In June 2019, the company earned a one-year accreditation from the Behavioral Health Center of Excellence.

She bought buildings as she grew. Napier said she bought the building she had been renting, then bought a second one for $180,000 during the pandemic and got a real estate license to keep the commissions. In May 2020, the company borrowed $400,000 under the Paycheck Protection Program, reporting 43 jobs, according to SBA loan data published by ProPublica; the loan was later forgiven. State records show eight more Indiana LLCs carrying the Stepping Stones Behavioral Solutions name, all now inactive. “By the end of 2022, we had eight facilities,” Napier said.

Federal data track the same climb. Recorded Medicaid payments to the company rose from $375,000 in 2019, a partial year in the dataset, to $3.3 million in 2020, $7.2 million in 2021, $14.1 million in 2022, and $16.6 million in 2023. By August 2024, Napier told Inc. the company had 10 facilities in Indiana and Mississippi and about 230 clients.

What the 2024 Rate Reset Did

Until the end of 2023, Indiana paid ABA providers 40% of whatever they billed. The result was widespread: FSSA’s analysis of managed-care payments for technician-delivered treatment at 199 billing locations in Q3 2022 found an average of $91 an hour and a range of $46 to $222. Effective Jan. 1, 2024, the state replaced that with a standardized fee schedule that, for managed-care plans, set a floor they had to meet and could exceed: $17.06 per 15-minute unit, or $68.24 an hour, for technician-delivered therapy, the code that accounts for about 83% of recorded payments to the company in the dataset. Statewide, Medicaid spending on ABA fell from $611 million in 2023 to $445 million in 2024, according to the governor’s ABA working group.

Under the old method, a provider’s payment rose with its own charges; the new schedule set a floor that applied to every provider. The federal data do not show hours, so they cannot say what any provider had been paid per hour. They do show that Medicaid paid Stepping Stones about $1,185 per claim line in 2023 and about $345 in 2024 for a nearly identical number of claim lines: 13,983, then 13,758. The dataset’s publisher calls state Medicaid agencies the authoritative source, so the figures are a proxy, not an audit.

In the first year of Indiana’s ABA fee schedule, recorded Medicaid payments to the company fell by more than two-thirds while its claim-line count held nearly flat.

Napier acknowledged the squeeze. “We recently went through rate decreases, and we had to reduce the number of breaks and tuition reimbursement incentives (for employees),” she told Indiana Minority Business Magazine in June 2024. In August, she told Inc. the company would probably open three more facilities that year.

The Freeze and the Anthem Cut

Napier dates the acute phase to the fall of 2025. Indiana Medicaid froze the company’s payments as part of a fraud review, and the review ended in February 2026 with no action, she told Inc. The freeze “created uncertainty and reputational harm because families, employees, and business partners naturally had questions about why payments had stopped,” she said. “From my perspective, the process did not provide the timeliness, transparency, or practical protections needed when a provider’s operating funds are suspended.”

Indiana’s rule, which follows the federal one, requires its Medicaid agency to suspend payments when it determines an allegation of fraud is credible (unless it finds good cause not to), refer the matter to the state’s Medicaid Fraud Control Unit, notify the provider in writing, and allow an appeal. No state Medicaid bulletin, attorney general release, or news report independent of Napier’s account names the company in connection with a suspension. The records BreakingNewsABA reviewed do not establish the review’s findings or the reasons for Anthem’s decision.

“Oversight is necessary, but the process should also account for the effect that a prolonged payment interruption can have on employees and patients before any finding has been made.” – Veronica Napier, founder and CEO, Stepping Stones Behavioral Solutions, to Inc. (2026)

The state was tightening on every side at once. On April 1, 2026, Indiana cut maximum rates for individual ABA services 6%, restructured group rates, and began a 4,000-hour lifetime allocation for intensive ABA, after which up to 15 hours a week of targeted therapy is covered, and further intensive treatment can be approved on medical-necessity review. The same Feb. 26 bulletin ended Medicaid ABA reimbursement for members 21 and older on Oct. 1, after a six-month transition for those already in treatment.

Then came Anthem. In April 2026, Napier told Inc. that the plan informed Stepping Stones it would no longer be in its Medicaid network. “It reduced both access to families covered through Anthem and the reimbursement associated with serving them,” she said. “We communicated with the appropriate parties and explored available options, but participation was not restored before Stepping Stones closed.” Hoosier Healthwise covers children up to age 19 and pregnant Hoosiers and includes the state’s CHIP program; Inc., citing state enrollment data, put Anthem’s share of its enrollment at 51%.

Anthem has not commented publicly on the decision. It was trimming its Indiana Medicaid network elsewhere in 2026: it ended participation for Columbus Regional Health’s physician practices effective July 1 and for Meridian Health Services, with about 18,000 Medicaid patients across 87 clinics, effective July 25. Meridian’s chief executive said Anthem gave no reason. Asked about Meridian, an Anthem spokesperson told The Herald Bulletin: “We routinely evaluate our provider networks to ensure they meet the unique needs of our diverse member populations.” Those disputes involved different providers and do not explain Anthem’s decision on Stepping Stones.

One Day’s Notice

Inc. reported, citing earlier trade coverage, that Napier’s assistant told managers on June 11 that the company would close effective June 12, and that the letter to families and staff went out at the end of that day. The letter said employees had been given 60 days’ notice of the company’s end. Many employees claim that they had not been given 60 days’ notice. Napier put it differently to Inc. “Employees had previously been warned that the company’s financial circumstances could result in closure, but the final decision and timing developed much more quickly than anyone wanted,” she said, adding that “the prior warning does not change the fact that the final closure happened abruptly for many people.”

She did not say what set the timing. “It became clear we could no longer continue responsibly,” she said. “I regret the disruption and hardship this caused employees and the families we served.”

The company has not published how many families and employees were affected. Inc.’s profile lists 51 to 200 employees; Napier’s August 2024 count was about 230 clients across 10 sites.

Nearly four months after the closure, the public record still shows an active company, though an active registration does not mean the clinics are open. Indiana Secretary of State records, as published by OpenCorporates, listed the company as active on Oct. 5; its last filing was a routine business entity report on June 8, 2026, three days before the closure notice. As of Oct. 5, its website still listed five locations and advertised a new clinic in Mississippi, and the Better Business Bureau marked it “Out-of-Business known or suspected.”

Where Things Stand in October

Napier aimed her last words to Inc. at regulators and health plans. “When payments or network access are interrupted before issues are resolved, the consequences extend beyond the provider,” she said. “Policymakers and managed-care organizations should design review and enforcement processes that protect public funds while also preventing avoidable harm to patients, employees, and responsible providers.”

Indiana’s ABA policy changes continue. Existing ABA agencies had to show by Aug. 1 that they held or had begun seeking accreditation for their ABA service line, which becomes mandatory on Oct. 1, 2027. New ABA agency enrollments and changes of ownership have been barred since June 6 under a six-month moratorium approved by federal regulators after they found that new agencies pose “a significant potential risk for fraud, waste, or abuse”; individual practitioners may still enroll, and the initial period runs into early December, when it can be extended in six-month increments. The next rate cut, of 4%, takes effect April 1, 2027.

AT A GLANCE

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