The $10 billion babysitter: How Medicaid turned autism therapy into a free-for-all

Published August 25, 2026 9:00am ET



The scale of Minnesota’s welfare fraud has stunned American taxpayers. “The largest Medicaid autism fraud case ever,” as put by the Justice Department, was among the schemes uncovered. The perpetrators built a yearslong operation that netted $46.6 million by exploiting autism therapy known as applied behavior analysis.

The Centers for Medicare and Medicaid Services recently released a 173-page “tool kit” prompted by “the rapid growth in utilization and costs” of ABA and by many states’ “significant fiscal and oversight concerns.” Minnesota is hardly an aberration — as the CMS tool kit demonstrates, Medicaid ABA spending is compromised nationwide, not only in “the Land of 10,000 Frauds.”

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