Due to a series of fraudulent cases in Florida’s Medicaid’s behavioral analysis therapy program, thousands of children with autism are left without any therapeutic resources while an investigation into the abuse of the system takes place.

While the Agency for Healthcare Administration, or AHCA, has selected a new vendor to administer the program, the process of reviewing every therapists credentials and to recertify every client has caused weeks of delays for individuals to receive regular therapy that, without Medicaid coverage, costs thousands of dollars a week.

The fraud in Medicaid’s behavioral analysis therapy program was discovered earlier this year, which demonstrated that the previous contractor who managed the program failed to catch fraudulent billing involving about 100 vendors, causing a loss to taxpayers believed to be in the millions.

Some patients, such as a seven-year-old Angelo, who previously attended therapy 40 hours a week, suddenly had his therapy cut off, and took 8 weeks to get reapproved. Fortunately, many therapists are continuing to provide therapy for children on medicaid at this time, hoping they will be paid at a later time. 

A child participating in ABA Therapy- Source: army.mil

George Zabala, one of the therapists that works with the previously mentioned child, Angelo, said in an interview with ABC Action News, “ You don’t drop the kid just because you’re not getting paid”.

Jennifer Borr, who built a private practice in South Miami known as Shine Bright Therapy to help children with autism and developmental disabilities, shared with the Miami Herald that this delay could “Close [her] doors”. The AHCA has not authorized service’s for Borr’s clients since February 2018, forcing Borr to pay staff out of her own pocket.

There is no date in place for when the delays will be over, and while the AHCA promises no Medicaid recipients will go without the services they deserve , according to the Miami Herald, thousands of patients without care prove this is not the case. To those struggling with the Medicaid delays, many clinics who are being forced to turn patients away are recommending they personally call AHCA to try and sort out their individual situation. Hopefully, these delays will be resolved shortly, but in the meantime our email and hotline are open for anyone who may need it, and we hope we can be of some help with such as turbulent issue.  

 

Recommended Posts