health
Indiana bars autism therapy provider from billing state Medicaid program
Indiana has barred a major autism therapy provider from billing its Medicaid program following the revelation that the company received some of the highest per-patient payments in the nation, marking an aggressive state action amid a broader federal crackdown on Medicaid fraud and waste.
TL;DR
- Indiana has barred Piece by Piece Autism Centers from billing the state's Medicaid program.
- The provider allegedly received some of the highest per-patient payments in the nation, averaging $340,000 per Medicaid patient in 2023.
- Piece by Piece was paid $58 million by Indiana for autism therapy services from 2019 to 2023.
- The state's action is part of a larger federal crackdown on Medicaid fraud and waste.
- Indiana's Family and Social Services Administration is terminating agreements to protect taxpayer funds, although audits for fraud are not concluded.
- Piece by Piece founder Meghann Mitchell reportedly made significant property purchases during the period of increased Medicaid billing.
- The decision raises concerns about potential disruptions in care for children who rely on Piece by Piece for applied behavior analysis.
- A recent HHS investigation found $56 million in improper Medicaid payments in Indiana, with $600 million nationwide related to autism services.
- Indiana has revised its reimbursement model to implement standardized, lower payments and service caps.
- Autism providers in Indiana are required to self-report past Medicaid abuses by April 3 to avoid federal investigation.