Latest fraud scheme targets taxpayer-funded autism therapy boom
Applied Behavior Analysis therapy is a lifeline for hundreds of thousands of American families — helping children with autism develop communication, social and daily living skills.But as Medicaid spending on...
By Fox News · Fox News
Applied Behavior Analysis therapy is a lifeline for hundreds of thousands of American families — helping children with autism develop communication, social and daily living skills. But as Medicaid spending on the autism therapy has exploded into the billions and with fraud on the rise, a partisan divide is emerging over how states should handle public assistance programs for the ballooning treatment option. Republican-led states like Florida have prioritized fraud enforcement and tighter oversight, while debates in states like Georgia have centered on reimbursement rates and preserving access to care. The scrutiny comes as the Trump administration has made it a focus of his second term to eliminate fraud, waste and abuse across federal programs, including Medicaid, a central policy priority. Supporters of stronger oversight argue that every dollar lost to fraud is money that cannot be used to provide care for children and families who depend on Medicaid-funded autism therapy. TRUMP ADMIN PAUSING OVER $1B IN MEDICAID PAYMENTS TO MINNESOTA, CALIFORNIA OVER FRAUD, COMPLIANCE CONCERNS According to Department of Health and Human Services (HHS) Medicaid provider spending data, Medicaid paid more than $5.15 billion between 2018 and 2024 under one of the primary billing codes used for Applied Behavior Analysis (ABA) therapy. Three providers received roughly $685 million in Medicaid reimbursements during that period. ABA therapy is one of the most common treatments for children with autism, using structured, one-on-one sessions to build communication, social and daily living skills. Much of that therapy is delivered by Registered Behavior Technicians (RBTs), entry-level workers who complete a 40-hour training program and work under the supervision of Board Certified Behavior Analysts, whose job it is to design and oversee treatment plans. MEDICAID FRAUD FEARS GROW AMID MASSIVE RED STATE BILLING SPIKE IN SECTOR THAT ALSO PLAGUED MINNESOTA As Medicaid spending on ABA therapy…