States eyeing providers of autism services

The state of Minnesota is investigating 15 autism providers amid allegations of fraud in Medicaid-funded autism services, following a national trend. The number of autism providers in the state has grown 700% over five years, with payments rising from $6 million to nearly $192 million. The Minnesota Department of Human Services (DHS) has withheld payments and referred cases to law enforcement when warranted.

Minnesota does not currently license autism centers, although DHS verifies credentials for reimbursement. Advocates like Idil Abdull, who co-founded the Somali American Autism Foundation, emphasize the need for licensing centers and stronger oversight to protect vulnerable children and ensure quality care.

While recent legislation licenses behavior analysts and increases reimbursement rates for intensive therapies, concerns remain about oversight and staff training at autism centers.

DHS's autism division is short-staffed, with three of four employees recently leaving. Rep. Kim Hicks, a former policy lead at DHS and mother of a child with autism, highlighted gaps in facility standards, worker licensing, and supervision. The DHS Office of Inspector General investigates suspected fraud, and findings can lead to provider billing restrictions and referrals to the Attorney General's Medicaid Fraud Unit.

Lawmakers and advocates are pressing for improved regulation, training, and monitoring to ensure safety, quality, and early intervention, with additional legislative focus expected in the next session.