Medicaid Fraud

For years, I have maintained the huge rise in the diagnoses of autism, ADHD, back pain, and other disabilities is fraud.

The autism scam in Minnesota finally brings the issue to a head.

Please consider the Wall Street Journal reports Why Is Autism Exploding? Welfare Fraud Is One Reason

Diagnosis rates of autism among children have more than tripled over the past 15 years. One reason, which Minnesota's welfare scandal lays bare with shocking details, is Medicaid fraud and abuse.

Medicaid pays healthcare providers big bucks to diagnose and treat children with autism—sometimes tens of thousands of dollars a month for a single child. Yet states rarely verify that kids who are diagnosed actually meet the medical criteria for the disorder or that they get appropriate treatment from qualified specialists.

The result: Children covered by Medicaid or the government-run Children's Health Insurance Program are 2.5 times as likely as those with private coverage to be diagnosed with autism. Many lower-income kids are labeled autistic merely because they have behavioral or developmental problems.

In 2014 the Centers for Medicare and Medicaid Services began requiring state Medicaid programs to cover autism therapy such as applied behavior analysis or ABA, a technique that uses positive reinforcement to improve social and communication skills. ObamaCare plans are also required to cover such therapy as an "essential benefit."

In Minnesota, the number of autism providers soared 700%, and payments to them increased 3,000% between 2018 and 2023. According to a federal indictment, Asha Farhan Hassan set up the ABA therapy provider Smart Therapy, which employed young relatives with no formal education beyond a high school education as "behavioral technicians."

Ms. Hassan and her business partners allegedly recruited parents by paying them monthly kickbacks of up to $1,500 a child. She worked with a licensed therapist "to get the recruited child qualified for autism services. There was no child that Smart Therapy was not able to get qualified for autism services," according to the indictment.