Posted on 03/05/2026 5:58:37 PM PST by SeekAndFind
Colorado’s Medicaid program made an estimated $77.8 million in improper payments and another $207.4 million in potentially improper payments for autism therapy, according to a February report from the Inspector General for the Department of Health and Human Services.
Auditors investigated $289.5 million in Medicaid payments from 2022 to 2023 that paid for more than 1 million claims for Applied Behavior Analysis—a therapy used to treat autism and developmental disabilities.
Each of the 100 claims reviewed contained at least one improper or potentially improper payment, suggesting a 100 percent failure rate.
Improper payments are not necessarily fraudulent. Payments are considered improper when the claim does not meet federal or state requirements. Payments are potentially improper when the submitted claim is so poor or unreliable that auditors cannot verify that the services were provided correctly.
In 93 of 100 claims examined, the billing providers either did not provide notes verifying that the therapy took place, didn’t provide the required signatures, or billed for more time than the notes indicated.
In 18 cases, the therapy that was supposed to be performed by a specialist—such as a Board Certified Behavior Analyst—was performed by staff without those qualifications.
In seven cases, the children receiving therapy lacked a current doctor’s diagnosis or referral on file.
In 88 cases, facilities billed for recreational activities that are not considered medical therapy, such as academic tutoring, day care, or custodial care. In one case, a facility billed for children swimming and playing on water slides.
In 76 cases, facilities billed for a full eight-hour day without subtracting time for naps, meals, or breaks.
The report concludes that Colorado made these improper payments because it did not provide effective oversight. The state did not regularly review Medicaid payments to catch errors and failed to give clear guidance to therapy centers on how to bill or what counts as therapy.
Additionally, the state didn’t properly check if its prior authorization contractors were following the rules when approving therapy for children.
While the audit focused on money, it also uncovered problems that could affect the safety and quality of care.
Some staff members had criminal convictions for weapons offenses, assault, or driving under the influence. In one case, three staff members at a facility providing care to an 11-year-old child with autism had criminal histories.
A non-credentialed technician had a felony weapons offense conviction three months prior to treating children. A registered behavior technician had been convicted of misdemeanor assault and physical harassment, such as a strike, shove, or kick. Another behavior technician had an aggravated misdemeanor weapons conviction.
The state did not require background checks for these workers.
The report comes as part of a series of seven Inspector General audits examining state Medicaid payments for autism therapy. Four are are complete and three remain in progress.
In previous audits, the agency estimated more than $120 million in improper payments and nearly $200 million in potential improper payments for Indiana, Wisconsin, and Maine.
The potential fraud, waste, and abuse in Medicaid autism therapy payments in Colorado was the highest among these audits.
The Office of Inspector General recommended that Colorado refund $42.6 million—the federal portion of the improper payments—to the federal government.
Also, the agency suggested that the state begin regular reviews of autism facilities to ensure they follow the rules and provide better training and guidance to facilities on documenting and billing for therapy.
The state of Colorado agreed to improve its guidance and conduct more regular reviews in the future, according to a statement. But it disagreed with the recommendation to refund the money, arguing that the audit derived its findings from a limited sample and didn’t have enough detail on the errors.
Further, Colorado argued that its Medicaid program does not require certification of behavior technicians before making payments, so the refund calculation based on this statute should be rescinded.
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The entire country is suffering from a fraudtism epidemic.
I wonder how much of our national debt is due to fraud (and therefore, the amount of debt service that is a huge part of each annual budget)...
Medicare benefits have been drastically cut in the past 3 years. It’s nothing like 2021 was. Seniors being screwed cause of this rampant fraud.
That’s what happens when you elect a homo Democrat for Governor.
Blame Congress. They spent all the money year after year, decade after decade with no oversight. Meanwhile we have a $40,000,000,000,000 debt, and growing and those SOB’s took off the debt limit.
Our debt problem can be summed up in one word ==> Uniparty.
“Someone’s got to go to prison, man”.
“Improper or flawed” = FRAUD. Obviously those in DC are forcing us to pay way too much in taxes. They take so much money from us that they can’t control or trace where it goes and who’s getting it all, as long as they get theirs. They loot and pillage and they don’t even have to wear a mask or carry a gun. They use the IRS to do their dirty work.
My father used to cure our autism with a leather strap. The cure worked fast.
Well put. Same.
All anyone had to do with all the autism centers was look at the population of autism children, look at the growth of autism centers, and then look for all those children to age into the public school system.
We should have seen a commensurate increase in special education/autistic children entering the school system over the years, but we haven't, indicating that it was a scam with phantom austistic children.
-PJ
He saved the taxpayers a lot of money and he never had to bail us out of jail.
Here’s how they defraud taxpayers in Minnesota.
Thieving Somali Abdinajib Yussuf pled guilty to one count of wire fraud—accused of running a fraudulent autism center. Yussuf opened Star Autism Center in St. Cloud Minnesota in 2020:
<><>he falsely claimed to provide one-on-one “therapy” to children with autism.
<><>Yussuf colluded with Somali parents to enroll kids into his phony center,
<><>kids enrolled were not actually diagnosed with autism.
<><>the thieving lying parents got kickbacks for enrollments
<><>Yussuf connived w/ a professional to “qualify” kids for autism services.
<><>Yussuf sent some $200,000 back home to Kenya,
<><>he purchased a $100,000 Freightliner semi w/ stolen tax dollars.
Court documents say Yussuf submitted millions of dollars worth of falsified claims for Medicaid reimbursement. He collected more than $6 million. Star Autism Center was raided by the FBI in 2024.
Another government program that needs to go away.
some of that autism is probably made up too.
Next year’s headline. Trump Cures Autism As the Country’s Autism Rate Drops To Lowest Level In 40 Years.
EC
So many government programs that give out money are ripe for easy pickings due to the lack of over site.
Deep state found most happy.
Everybody gets a whack at the cash if nobody is looking.
“100 percent failure rate.”
Check the software:
Deloitte IES Integrated Eligibility System signs the poor up for Medicaid, CHPS, SNAP/EBT, WIC, TANF, Sec8, etc. Deloitte IES has a high rate of dead who are active, DUPs where 1 person has 2 or 3 IDs many other features of bad software design.
Gainwell Technologies receives the garbage data from Deloitte IES and processes the claims. In GA the single biggest problem of Gainwell is in handling the garbage data it receives from Deloitte.
Colorado has a history of problems in specifying the requirements of its vendors, and in monitoring the quality of the vendor’s software.
RFK/DR OZ, the fed’s pay for the vendor garbage. Dr Oz and Pam Bondi should prosecute Deloitte for fraud.
My father used to cure our autism with a leather strap. The cure worked fast.
9 posted on 3/5/2026, 8:44:47 PM by FlingWingFlyer (The Supreme Court Sucks. Time for the old dinosaur to go along with the U.N. and NATO.)
Bravo! Good one!
I laughed so hard I almost blew coffee out my nose.....LOL!
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