Colorado made at least $77.8 million in improper payments for Medicaid services for children with autism and must refund the federal government $42.6 million, federal officials said Monday.
Auditors at the federal Office of the Inspector General found the state Medicaid program has been improperly covering care by uncredentialed behavioral technicians for children with autism.
The audit released Monday comes as the state is already dealing with a $1 billion budget shortfall and cuts to Medicaid benefits that have affected multiple programs for people with low incomes and disabilities.
The therapy, called applied behavioral analysis, uses playtime and step-by-step repetition to improve communication, attention span and life skills. The number of autism centers that provide the therapy has increased in Colorado in recent years as the number of people diagnosed with autism has grown.
Colorado has more than 6,600 certified technicians and an estimated 1,500-2,000 who are not certified but are providing therapy. Certification requires a 40-hour course, a written test and on-the-job supervision.
The OIG has been investigating applied behavior analysis therapy in multiple states, identifying what it calls “questionable billing patterns.” Colorado’s Medicaid payments for this type of therapy jumped to $163.5 million in 2023 from $60.1 million in 2019, federal officials said.
The audit looked at whether the state’s Medicaid payments for the therapy in 2022 and 2023 complied with federal and state law. In a sample of 100 people, auditors found all 100 included at least one claim that was improper, the OIG said.
The federal agency said Colorado must refund $42.6 million in federal money, as well as conduct periodic statewide reviews of payments for autism centers offering applied behavior analysis therapy, including places such as Soar Autism Center and Action Behavior Centers.
This is a developing story that will be updated.
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