In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families. Scams plague the world of autism. Some involve shady or abusive providers.
A series of high-profile scandals made Minnesota the center of President Donald Trump’s crackdown on immigration and alleged fraud in Medicaid, the government health insurance program for low-income individuals and people with disabilities. To avert $2 billion in cuts, the state paused Medicaid reimbursements to thousands of providers like Wright in December while it implemented new anti-fraud measures.
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While providers and patients acknowledged the need for safeguards, they say the state’s response undermines programs that made Minnesota a leader in autism therapy and assisted living services. They also warn that anti-fraud measures could deter workers from entering the care economy and increase government spending as patients without services turn to emergency rooms or require more intensive care later.
“To think that this is going to somehow create savings is a complete illusion,” said Ed Funk, a resident of Golden Valley, a Minneapolis suburb. Funk retired in February to help his wife care for their 30-year-old daughter Sophie, who has autism and a history of digestive and developmental issues. Sophie, who is slated for surgery to remove her colon, relies on the state’s night supervision and home support programs, Medicaid services deemed high risk for fraud. She needs 24-hour care from Learnability, but the state legislature recently enacted measures to cut down home support to no more than six hours a day.
Early results of the anti-fraud crackdown have left some providers and patients questioning whether the payoff was worth the disruption. Of the 2 million claims suspended for review between January and mid-May, only 0.06 percent were denied, according to state data. Its revalidation process did not reveal cases of fraud, but the Minnesota health agency flagged 59 providers — about 1 percent of those it had to revalidate — for further review.
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“There’s a disconnect between policy decisions and how they impact communities they serve,” said Maren Christenson Hofer, executive director of the Multicultural Autism Action Network and mother to a 15-year-old child with autism. Some of the families her nonprofit served had to quit their jobs to care for their children when providers cut services during the payment freeze.
“The fraud prevention is causing so much more harm than fraud ever did,” Hofer said. “You took a financial problem and you turned it into a problem of survival.”
