Authorities in North Carolina are investigating a massive surge in Medicaid billing tied to autism therapy services amid growing nationwide concerns over fraud, abuse and weak oversight in publicly funded healthcare programs.
State Auditor Dave Boliek told Fox News Digital that autism therapy billings in North Carolina increased from roughly $1.4 million to more than $660 million annually within five years, a spike he described as alarming and one that demands a full investigation.
Receive breaking news alerts
Immigration, New York, Dominican Republic and investigative news delivered directly to your phone and computer.
Free — unsubscribe anytime.
Boliek said the therapies are essential for children and families who genuinely need them, but warned that the current system contains major regulatory weaknesses that may be enabling fraud and excessive billing practices.
Among the issues identified, the auditor pointed to cases in which multiple clinical providers allegedly billed Medicaid for the same patient during the same period of time. He said some of those actions could be illegal, while others may be technically allowed because of weak oversight rules within the state Department of Health and Human Services.
During a legislative oversight hearing on March 10, 2026, the North Carolina Department of Health and Human Services confirmed that Medicaid spending on ABA autism therapy increased by 347 percent between 2022 and 2025. State projections estimate the program could reach $842 million in fiscal year 2026 and surpass $1.14 billion by 2027.
The investigation comes as similar Medicaid fraud cases emerge in states including Minnesota, California and Ohio. In Minnesota, federal investigators uncovered alleged schemes involving fake therapy sessions, untrained staff and payments made to parents to keep children enrolled in treatment programs. According to federal officials, Minnesota’s autism program budget grew from $3 million in 2018 to nearly $400 million in 2023.
Boliek said his office is now working with lawmakers to strengthen enforcement measures, expand Medicaid auditing resources and increase the use of artificial intelligence to detect suspicious billing patterns.
The auditor argued that fraud networks are already using advanced technology and warned that state agencies must respond with similar tools to protect taxpayer money and ensure services reach those who truly need them.
Comments (0)
Be the first to join the conversation.