EXCLUSIVE: American autism care providers who backed the Trump administration’s crackdown on Medicaid fraud are now sounding the alarm, warning that efforts to root out abuse could have unintended consequences after reimbursement cuts put therapy for Georgia foster children at risk.
The Autism Families Alliance, which describes itself as a national advocacy organization dedicated to supporting Applied Behavior Analysis providers and the families who rely on their services, said that efforts by the Trump administration and state leaders to fight fraud have gone too far, potentially leaving many of Georgia’s children with autism in foster care without the care they need.
This warning is in response to a move by Amerigroup, the insurer that covers Georgia’s foster children through Medicaid, to cut what it pays autism therapy providers by 30%. Providers caution that they may no longer be able to afford to treat vulnerable children and that many foster families will be unable to switch them to another insurer.
“It’s scary to see that so many different things are being slashed in terms of Medicaid, and that we’re seeing this drastic outcome,” Taylor Sanders, a family advocate at the Autism Families Alliance, told Fox News Digital. “It’s so important that we keep in mind that children with autism are in a very vulnerable place where they’re still needing to learn safety skills. There are some children who have extremely aggressive behaviors, challenging behaviors. So, when we’re seeing some of these cuts, we’re seeing it affect the providers who are able to provide access to these services.”
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“If we’re not able to provide a good amount of pay to our providers, we’re not able to make sure they’re set up for success to be able to give some of these services, and we’re going to see less and less children being able to access services at all,” she added.
Sanders said 75% of clinics will have to close their doors or stop serving foster kids due to the massive cuts.
The 30% cut will not only affect providers’ ability to provide access to these families, but it will also limit foster children’s opportunities to learn essential skills, according to Sanders. Foster children with autism depend on regular therapy to develop everyday skills, but a sudden loss of that support could set them back.
“If they don’t learn these school skills at an early intervention or an early age, it’ll be a lot more costly later on,” she said.
In August, the Autism Families Alliance put its support behind the Trump administration’s crackdown on Medicaid fraud, arguing that the alleged theft of millions of federal funds has hurt both taxpayers and children with autism who rely on those services. Some states, including Georgia, have also taken steps to enhance oversight of autism services.
The group backed eliminating fraud and prosecuting suspected criminals, but also feared that broad federal and state efforts to root out fraud could unintentionally make it more difficult for legitimate providers to care for children with autism. The coalition called on policymakers to ensure fraudsters are removed from the system without creating what they described as unnecessary barriers for families of vulnerable children seeking care.
Now, the group says Georgia’s foster families face the risk that they had previously raised concerns about.
“I think fraud should be prosecuted by all means,” Sanders said. “Anybody who is engaging in fraudulent behavior should be prosecuted to the highest extent of the law. Are we able to not only tackle the fraud, but still give access to services for our children? Why can’t we do both at the same time?”
“What’s really happening here is we’re going in with a sledgehammer when really we should be going in with a scalpel,” she continued, adding that officials need to be “approaching this in a way where it’s not going to totally obliterate the care to our families.”
One Georgia foster mother has already been told her nearly 3-year-old son’s provider may be forced to stop treating him after he started making progress, according to the Georgia Recorder.
“Reforms that improve care, increase efficiency and prevent abuse are something we all support, but when those efforts make it harder for children with autism to get the care they need, something has gone terribly wrong,” Kelsey Bennett, a family advocate with the Autism Families Alliance, told Fox News Digital.
“No one wants to eliminate waste, fraud and abuse more than the providers who dedicate their lives to caring for these children. Every taxpayer dollar should go toward helping the people it was intended to serve. But you can’t fix a system by making it harder for vulnerable children to get help. Reforms that end up hurting the very children the system is supposed to protect are not in Georgia’s best interests,” she continued.
Bennett urged Georgia’s lawmakers “to bring everyone to the table, including the Medicaid managed care companies and the providers who care for these children every day.”
“By listening to those on the front lines and working together, they can find a better way forward that improves efficiency without putting children’s access to care at risk,” she said.
“Children with autism, especially those in foster care and those welcomed into loving foster families, already face enough challenges. Their families shouldn’t have to worry about whether the care they depend on will suddenly disappear. Georgia’s leaders need to step in, address these cuts and make sure these children aren’t the ones paying the price for efforts to save money,” she added.
