HHS audit finds $500M in potentially fraudulent autism provider payments in four states
A new federal audit found $500 million in potentially improper Medicaid payments for autism-related services in four states. The Centers for Medicare and Medicaid Services has issued a nationwide call for all 50 states to re-evaluate providers and remove those deemed illegitimate.
A federal audit identified millions of improper or incorrect payments tied to supposed autism care in Indiana, Wisconsin, Maine, and Colorado. The audit found up to $600 million in Medicaid benefits were paid out across those four states, with potentially improper billings that included services that did not include therapy and payments for patients who were not properly diagnosed with autism. The Centers for Medicare and Medicaid Services has given states 10 business days to respond and say whether they will conduct the re-evaluation, along with a broader 30-day deadline to provide a timeline and strategy for how they plan to root out potential fraud. Dr. Mehmet Oz, CMS administrator, called on governors to act now, stating that fraudsters are draining Medicaid funds, costing taxpayers billions every year. The Trump administration has been cracking down on potential Medicaid fraud, including singling out Minnesota fraud schemes and expanding scrutiny to other states.
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