Response to Peers' Medicaid Greed

We want our families and community to understand where Partners in Autism stands in light of recent reporting about Medicaid billing practices in the autism therapy industry.

 

Recent reporting has brought national attention to troubling billing practices among some autism therapy providers. We encourage families to review the reports below for more information. Some may require a subscription, but they provide important details about the issues currently affecting autism therapy services.

 

Wall Street Journal - most detailed, requires a subscription or ACPL Library Card*: https://www.wsj.com/health/healthcare/autism-therapy-medicaid-payments-640aa435?mod=Searchresults&pos=2&page=1 (*Allen County Public Library card holders can access the WSJ for free at www.acpl.lib.in.us/digital-resources)

 

Diya TV News - less detail but no subscription required: https://diyatvusa.com/investigation-reveals-medicaid-autism-therapy-providers-billing-millions-for-small-patient-pools/

 

As you can see in the investigations linked above, some providers billed Medicaid extraordinary amounts for relatively small numbers of patients while taking advantage of reimbursement policies that allowed it.

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This was not minor overbilling. In some cases, a single provider collected tens of millions of taxpayer dollars while serving only a small number of patients. 

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We want our families to know something clearly:

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Partners in Autism did not engage in Medicaid price gouging.

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While Medicaid rules at the time allowed providers to dramatically inflate their billing rates, we made a conscious decision not to take advantage of that highly questionable allowance. We also know and work closely with other providers who made the same ethical choice.

 

Taking advantage of a system designed to help children receive therapy was never ethical.

 

We believed even then that exploiting taxpayer-funded programs intended for vulnerable children is not only unethical but immoral.

 

It was obvious that billing practices like those described in these investigations would eventually have consequences for families and children. When public funds for therapy are pushed beyond reasonable limits, the result is exactly what families are experiencing today: cuts to medically necessary services.

 

Every day at Partners in Autism, we fight those cuts. Every day, we watch authorizations reduced and medically necessary therapy hours challenged. Every day, we advocate for children whose progress depends on consistent access to care.

 

Our Behavior Analysts, Behavior Technicians, and all other staff see firsthand the impact these decisions have on families.

 

Meanwhile, many of the providers who benefited from these inflated billing practices—including some in our own community—have offered no apology and no accountability for the strain placed on the system that serves these children. As reported in the investigations above, some of those who benefited from these billing practices accumulated extraordinary personal wealth during that period, while others remain silent as families now fight to preserve the medically necessary therapy their children depend on.

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To those leaders in our industry who chose to exploit this system while it was possible—many of whom are my peers in this field:

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You knew these funds came from taxpayers and were meant to support therapy for children with autism.

 

You knew that excessive billing practices would eventually put the entire system at risk. 

 

Greed had consequences. 

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Yet you chose profit. Today, children and families are paying the price for your decisions.

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Partners in Autism chose a different path.

 

Partners in Autism was founded by my family after we experienced the life-changing impact of autism therapy within our own home. We have multiple autistic individuals in our family and among our staff, and many members of our team share personal connections to autism.

 

Because of that, this work has never been just a business to us. It is very personal.

 

We understand firsthand what access to therapy means for a child and for an entire family.

 

We would never choose profit over our integrity—especially when the funds involved were meant to support therapy for children.

 

We billed responsibly.

We served families ethically.

We advocated for children every step of the way.

 

Every member of our team can say proudly that we never acted in a way that compromised the services children rely on.

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Children’s therapy should never be treated as an opportunity for excessive profit.

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We are deeply grateful to the families who have placed their trust in Partners in Autism throughout the challenges of constant Medicaid changes. We do not take that trust lightly.

 

Our focus has always been clear: protect access to medically necessary therapy and serve families with integrity—regardless of how difficult the current environment becomes.

 

That focus remains unchanged today.