Recent audits (federal HHS OIG + state reviews in MN, NE, NC, CO, IN, WI, ME) show Medicaid spending on autism ABA therapy surged 200-300%+ nationally 2018-2024, far faster than overall Medicaid or diagnosis growth in some states.
Examples: MN costs up ~1,600%, NE ABA spending +1,700%. OIG found 100% of sampled claims in 4 states had issues—missing records, no supervision logs, credential gaps—equaling $198M improper payments (up to $600M potential).
Not all fraud; some from weak oversight or policy gaps amid rising demand. States cutting rates, adding reviews; White House formed fraud task force. Goal: curb waste while preserving access for kids who need it. Primary sources: OIG reports (e.g., Colorado: $77.8M improper 2022-23).