Autism is becoming more prevalent due to greater awareness of the problem and more frequent diagnosis. In a complex society it is arguably harder for autistic children to fit in. On the farm 100 years ago, it probably mattered less when a child had problems with social skills. Today social media is likely to exacerbate the problem. Thus, the parents of autistic children are looking for help, which often comes in the form of Medicaid. Milking Medicaid for substandard care (or nonexistent care) is a major problem that states appear to be doing little to address. The following is from the Wall Street Journal:
Behavioral therapy is an especially ripe target for people looking to game Medicaid. Diagnostic standards can be elastic, and states provide little oversight of providers and pay claims without requiring verification of treatment or benefits. While insurers that administer Medicaid benefits have an incentive to police fraud, autism treatment has become a fee-for-service free-for-all.
Fraud in state Medicaid programs became known partly due to recent revelations of widespread fraud in Minnesota.
Minnesota is a case study. According to a federal complaint, 27-year-old Abdinajib Hassan Yussuf set up a fly-by-night autism center claiming to provide one-on-one therapy for autistic children. He allegedly worked with medical professionals to have children diagnosed with autism and paid kickbacks to parents to enroll them in his center.
He also employed teenage relatives with no formal education or training and raked in more than $6 million in Medicaid money, some of which he wired to Kenya. Mr. Yussuf pleaded guilty.
Examples from Minnesota are being discovered in other states. Fraud follows a similar pattern. Parents struggling with daycare are enticed to enroll their children in autism centers. In some cases, parents are offered financial incentives to enroll their children. Many children do not necessarily have an official autism diagnosis. They do not have an individual treatment plan. The providers do not have clinical experience or medical credentials. The autism centers bill high hourly rates for therapy, and the number of hours often far exceeds what is normal or provided. State Medicaid programs pay huge fees without question for children engaged in recreational activities rather than therapy that was not delivered. More from WSJ:
Minnesota is far from alone, judging by audits by the U.S. Health and Human Services Department’s Inspector General of Medicaid autism spending in other states. An IG audit released last week estimated that 99% of Colorado’s Medicaid payments in 2022 and 2023 for autism treatment were improper or likely improper, totaling $285.2 million.
Nearly all providers failed to submit the required documentation for at least some claims, and a quarter billed the state for treatment provided by staff without appropriate credentials. Many autism centers billed Medicaid at more than $50 an hour for autism “treatment” when children were playing games, napping or eating. Many provided little more than glorified day care.
Experts warn that widespread fraud, like found in Minnesota, is probably just the tip of the iceberg. Moreover, waste and abuse likely exceeds fraud. It is easy to spot fraud when it is blatant, with daycare masquerading as therapy. It is harder to identify costly but ineffective therapy sessions by autism treatment centers who go through the motions but provide care that is not well tailored or effective. Parents are often complicit due to kickbacks or merely happy to save on daycare. More from WSJ:
The welfare-state fraud story is turning out to be enormous. As the evidence emerges, keep in mind that the root problem isn’t fraudsters, who are always with us. It’s the programs that make it so easy for criminals to scam.
Fraud within the Medicaid program will continue if states blindly pay claims without verifying the services provided. Furthermore, the federal government needs to force states to bear the entire cost of fraud, since states run their own programs. Better yet, provide a block grant where states control the money and do not get additional funds for waste, fraud, and abuse.
Read more at WSJ: The Medicaid Autism Racket
All the fraud cases in Minnesota followed the same pattern. They started out with small, single digit, low million-dollar outlays and ballooned to over $100 million within five or six years. Feeding our Future went from $3.4 million to a total outlay of $250 million in a handful of years. The housing assistance outlay went from $2.5 million to $104 million in a similar time frame. The autism scandal went $1.3 million in 2017 to $228 million in 2024. If a program has an annual budget of $2 million, $3 million or $4 million and balloons to more than $100 million, wouldn’t the state raise some questions? Should that prompt the state to investigate?
The Wall Street Journal Caught Up To What We’ve Been Saying About ABA Fraud
Parents keep sending me the new Wall Street Journal piece about the “Medicaid autism racket.” Behind the scary headline is something important: they are finally admitting the fraud pattern many of us have been documenting for years.
Here are 3 things I want you, as parents of autistic kids, to see clearly:
1️⃣ I named the Minnesota ABA fraud pattern long before WSJ “discovered” it
Months ago, I published “Minnesota fraud started with Fake Autism Therapy ABA Clinics,” breaking down exactly how fake “autism therapy” centers used the EIDBI program to bill Medicaid for what was essentially unlicensed childcare. I walked through the same clinics and defendants now in the news:
– Teens and relatives listed as “behavior techs”
– Kids parked on screens or napping while full‑day “therapy” was billed
– Kickbacks to families so the clinics could submit even more claims
Those exact cases are now being used by WSJ as proof of a Medicaid “racket.” Parents should know: this is not new information. Autistic‑led researchers and advocates have been ringing this alarm for a long time.
2️⃣ ABA’s “gold standard” billing machine is the *real* built‑in scam
For years, I’ve explained how ABA was set up as a high‑volume billing machine: special CPT codes, “gold standard” branding, and pressure for 20–40 hours a week per child. That structure is what makes fraud so easy.
Now, federal audits are confirming what we warned about: in some states, *every single* sampled Medicaid autism claim to ABA providers was “improper or potentially improper,” adding up to hundreds of millions in overpayments.
In other words: the system is working exactly as it was designed—great for corporate ABA revenue, terrible for autistic kids and for honest families who just need real support.
3️⃣ They copied the fraud part, but erased the autistic harm part
The WSJ and similar outlets are finally copying the “fraud” chapter of this story:
– Explosive ABA spending
– Massive overpayments and improper claims
– Fake autism clinics using kids as billing props
But they leave out the chapter autistic people have been writing for years: ABA is not just a financial problem, it is a human rights problem. The same programs that are overbilling Medicaid are also training children to mask, ignore their own bodies, and comply at all costs. That is linked to trauma, anxiety, and suicidal thinking in autistic adults who went through it.
#banABA and STOP #medicaidfraid We the #ActuallyAutistic said it first.
Read the Fraudit https://doogri.org/2026/03/09/cms-audit-request-san-diego-pilot-march-6-2026/n
I live about 7 miles from the areas in Minneapolis that had the most Medicaid fraud. Two comments:
1. The laziness of state bureaucrats in the health departments has been pretty spectacular for some time.
2. A friend of mine who is active in state politics claims that Gov. Walz and Atty General Ellison and Rep. Ohmar quietly promised not to investigate Somali scams, in exchange for a promise of votes. I have no proof of this. Part of me is skeptical because the number of votes involved is not huge on a statewide basis, but you never know.