Report reveals widespread billing issues in Minnesota autism program

A program that provides support services to Minnesota children with autism has long faced scrutiny for possible Medicaid fraud over accusations of payment for services that were never provided.

Now, a long-awaited report has revealed widespread billing irregularities with the program, which grew exponentially in recent years.

Ninety percent of claims that Medicaid-funded autism intervention providers billed the state for over a four-year period veered from acceptable standards, according to the initial report from an outside firm tasked with improving state fraud protections. But state officials noted that doesn’t mean all of those claims are fraudulent.

The staggering number of questionable autism claims is just one finding from the Feb. 6 report meant to help the Department of Human Services strengthen its fraud-fighting measures. The agency is contending with a massive welfare scandal that prosecutors say could total billions of dollars in stolen funds. President Donald Trump has pointed to the situation as a reason to send thousands of federal agents to Minnesota.

In October, the state contracted with Optum, a subsidiary of UnitedHealth Group, to spend a year reviewing and developing a stronger oversight system for payments in Medicaid programs.

John Connolly, the agency’s deputy commissioner and state Medicaid director, said at a Feb. 6 news briefing that the department continues to share fraud allegations with the state Attorney General and U.S. Attorney’s Office, but mass resignations of federal prosecutors have complicated efforts to prosecute fraud in Minnesota.

“We’re forwarding the information, as we always have, in the usual channels,” Connolly said. “Who’s receiving that information, and who’s investigating at the U.S. Attorney’s Office? We’re just not sure at this point, given how many folks have departed that office.”

The findings don’t identify a specific dollar amount of alleged fraud across the array of services. Rather, the report claims that the state could save over $52 million if it implements a slew of changes to root out billing irregularities.

Prosecutors have claimed that fraudulent providers pilfered up to $9 billion from social programs, but Connolly said his department can’t nail down a number when investigations remain ongoing.

“We don’t know that to be true, and numbers that are placed out there at this point are speculative,” he said.

The report excludes the names of providers but reveals the types of programs vulnerable to an “egregious pattern” of irregular claims, which Connolly said range from billing for services that aren’t “clinically justified” to nonsensical documentation.

The programs that stood out include autism intervention, nonemergency medical transportation and housing stabilization services.

Connolly said it could take years for the state to reimagine its social service programs to prevent further wrongdoing — a major focus of the upcoming legislative session. Optum, meanwhile, will continue working with DHS.

Huge sections of the initial report are redacted, including pages that detail what makes certain high-risk programs vulnerable to fraud. Connolly said the redactions are intended to prevent bad actors from gaming the system, though he added officials will share unredacted policy recommendations with lawmakers as the session gets underway.

The broad review to catch improper payments has caused anxiety among some disability service providers across Minnesota. Many have said that payment delays during the reviews make it difficult for good organizations to operate and forced some to close entirely.

Observers have for years traded rumors about possible misconduct in the autism intervention program, formally called Early Intensive Developmental and Behavioral Intervention. The FBI raided two Minnesota autism centers in December 2024 months after authorities began probing potential Medicaid fraud.

A search warrant indicated that authorities discovered the autism fraud scheme partially through the U.S. Attorney’s Office prosecution and FBI investigation into Feeding Our Future, which saw scores of people indicted for billing for meals for needy children that were never provided.

Prosecutors have so far charged several people with defrauding the service, which the state and federal government funds. Minnesota spent at least $229 million of Medicaid dollars on the program in 2024.