Updated
Updated · Fox News · Aug 1
Florida Launches Medicaid Fraud Crackdown After $5.15 Billion in Autism Therapy Payments
Updated
Updated · Fox News · Aug 1

Florida Launches Medicaid Fraud Crackdown After $5.15 Billion in Autism Therapy Payments

3 articles · Updated · Fox News · Aug 1

Summary

  • Florida rolled out a statewide Medicaid Integrity Initiative last month to tighten provider screening, boost fraud detection and increase oversight of autism therapy billing.
  • More than $5.15 billion in Medicaid payments flowed through a key Applied Behavior Analysis billing code from 2018 to 2024, with three providers alone receiving about $685 million.
  • Florida said it recovered over $72 million in improper Medicaid payments in the past year and blocked hundreds of behavior analysts from Medicaid over documented fraud concerns.
  • Federal scrutiny has intensified after Minnesota cases alleging $46.6 million and $14 million autism-therapy fraud schemes, while CMS said rapid ABA spending growth requires stronger program-integrity safeguards.
  • The push highlights a wider split over autism therapy policy: Republican-led states are emphasizing fraud enforcement, while Georgia lawmakers have fought a 20% reimbursement cut as service use rose more than 300%.

Insights

Will aggressive state crackdowns on Medicaid billing fraud unintentionally strip vital therapy access from vulnerable children?
What hidden loopholes in 15-minute billing codes allowed fraudulent clinics to exploit the booming autism therapy market?