Autism care providers who supported the Trump administration’s Medicaid fraud crackdown now warn a 30% payment cut in Georgia threatens therapy for foster children who need it most.
American autism providers that stood with the push to root out Medicaid abuse are sounding an alarm over how the effort is landing on the ground. In Georgia, the insurer that covers foster children through Medicaid has slashed what it pays therapy providers by 30%, and advocates say legitimate clinics may stop serving those kids.
Fox News reported that the Autism Families Alliance, a national group that backs Applied Behavior Analysis providers and the families who rely on them, previously endorsed the crackdown. In August the alliance put its support behind the administration’s drive against fraud, arguing that stolen taxpayer dollars hurt both the public and children with autism who depend on those services.
Now the same group says the combination of federal and state fraud-fighting steps, paired with the insurer’s deep cut, risks leaving many Georgia foster children with autism without care.
Amerigroup is the managed-care company that covers Georgia’s foster children through Medicaid. It moved to cut reimbursements to autism therapy providers by 30%. Providers caution they may no longer be able to afford to treat these children. Foster families cannot simply switch to another insurer.
Taylor Sanders, a family advocate at the Autism Families Alliance, said 75% of clinics will have to close their doors or stop serving foster kids because of the cuts.
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 had started making progress, according to reporting cited by Fox News from the Georgia Recorder.
Sanders described the stakes for early intervention in plain terms.
"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 also warned that children with autism often need safety skills and help with aggressive or challenging behaviors. When pay drops, access shrinks.
"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,"
The advocates are not soft on fraud. Sanders was clear that criminals who steal Medicaid dollars should face the full force of the law.
"I think fraud should be prosecuted by all means. 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?"
She argued the current approach is too blunt.
"What's really happening here is we're going in with a sledgehammer when really we should be going in with a scalpel."
Kelsey Bennett, another family advocate with the alliance, struck the same balance. She said reforms that improve care, raise efficiency, and stop abuse deserve support. But when those efforts make it harder for children with autism to get treatment, the system has failed its purpose.
"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."
Bennett called on Georgia lawmakers to bring Medicaid managed-care companies and the providers who work with these children every day to the same table. She said leaders need to address the cuts so foster children are not the ones who pay the price.
Some states, including Georgia, have already tightened oversight of autism services. The alliance had warned earlier that broad measures could unintentionally squeeze honest providers. Georgia foster families, it now says, are living that risk.
Children with autism in foster care face layered challenges. Many are still learning basic safety skills. Early therapy can change their trajectory and reduce long-term costs to taxpayers and families. When clinics cannot keep the doors open for this population, those gains vanish.
Sanders put the human cost simply: it is scary to watch Medicaid services get slashed and then see the drastic outcome for kids who have nowhere else to turn.
The alliance describes itself as dedicated to supporting providers and the families who rely on them. Its message is consistent: prosecute fraud fully, protect taxpayer dollars, and do not obliterate care for legitimate patients in the process. Officials, it says, should approach the problem so that families are not left without help.
Related enforcement actions have already produced major cases, including a referenced $46.6 million Medicaid scheme described as among the largest autism-related fraud busts. That kind of accountability is exactly what the providers say they support. The question they raise is whether payment policy and oversight can target thieves without cutting off foster children who did nothing wrong.
Georgia’s leaders have the ability to sit the insurer, the providers, and state officials down and fix the reimbursement problem while keeping the pressure on fraud. Taxpayers deserve clean programs. Foster kids with autism deserve the therapy that helps them learn and stay safe. Both goals can stand together when the tools match the job.
Root out the thieves. Keep the care for the children who need it. That is the standard any serious reform should meet.
