Autistic Kids in Florida May Lose Care as Medicaid fraud Investigation Continues
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On July 26, 2018, state investigators revealed that six behavioral therapists in Florida billed the state for “impossible” days of service that at times indicated they worked for more than 24 hours in a day. The six therapists, who worked with low-income children with autism, were then subsequently terminated from the Medicaid program.
The company that employed them, DRA Behavioral Health, was among four South Florida behavioral therapy companies sanctioned by the Agency for Health Care Administration (AHCA) for failing to pay fines, hiring unqualified therapists and failing to disclose required information to the state.
Is AHCA Delaying Health Care?
While AHCA continues its probe into behavior analysis services paid for by Medicaid, schools and programs say the agency is dragging out authorizations for therapy and approvals of new therapists. Thus, AHCA is effectively preventing children from getting therapy for months while reducing the costs to the state.
Advocates claim that AHCA used wrong or outdated information as a reason to suspend their therapists from Medicaid and then forced the provider to repay thousands of dollars.
In response, AHCA has urged parents of children with Medicaid to contact the agency if they are having difficulty getting behavioral analysis services as the state continues to add new providers to meet demand. For more information, click here.
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Sources:
Chang, Daniel. “Autistic kids could lose care as Florida cracks down on Medicaid fraud.” Miami Herald. (July 26, 2018). Web.
Viteri, Amy. “Autistic children caught up in Medicaid fraud investigation.” (August 7, 2018). Web.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
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