WHAT YOU NEED TO KNOW
- Amerigroup is cutting Medicaid reimbursements to Georgia autism therapy providers serving foster children by 30%.
- Taylor Sanders said 75% of clinics may close or stop treating foster children because of the cuts.
- The Autism Families Alliance supports prosecuting Medicaid fraud but warns that broad reforms could restrict legitimate autism care.
- Advocates are urging Georgia lawmakers, insurers and providers to develop efficiency measures that preserve children’s access to therapy.
American autism care providers who supported the Trump administration’s crackdown on Medicaid fraud are warning that reimbursement cuts could leave Georgia foster children without vital therapy. Their concern centers on a 30% reduction in payments to autism therapy providers serving children covered through Medicaid.
Amerigroup, the insurer covering Georgia’s foster children through Medicaid, is cutting what it pays autism therapy providers by 30%. Providers caution that the reduction could make treatment financially impossible, while many foster families may be unable to move children to another insurer.
The Autism Families Alliance, a national advocacy organization supporting Applied Behavior Analysis providers and families using their services, said federal and state fraud prevention efforts have gone too far. The group warns that many Georgia foster children with autism could lose access to care.
Taylor Sanders, a family advocate at the Autism Families Alliance, said the scale of Medicaid reductions was frightening. She emphasized that children with autism can remain highly vulnerable while they are learning safety and other essential skills.
"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," Sanders 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."
Sanders said the cuts affect whether providers can continue offering services. She added that inadequate provider payments could mean fewer children receive autism therapy at all.
Sanders estimated that 75% of clinics will have to close or stop serving foster children because of the cuts. Such closures would restrict access for families and reduce opportunities for children to develop everyday abilities through regular therapy.
Foster children with autism depend on consistent therapy to build essential skills, according to Sanders. An abrupt loss of support could interrupt that progress and create greater costs later.
"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," Sanders said.
In August, the Autism Families Alliance supported the Trump administration’s Medicaid fraud crackdown. The organization argued that the alleged theft of millions in federal funds harmed taxpayers and children with autism who rely on services financed through the program.
Georgia and other states have also moved to increase oversight of autism services. Although the alliance supported eliminating fraud and prosecuting suspected criminals, it warned that broad enforcement measures could create unnecessary barriers for legitimate providers and families seeking care.
The coalition urged policymakers to remove fraudulent operators without disrupting services for vulnerable children. It now says Georgia foster families face the precise access risk that it had previously raised.
"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."
Sanders questioned why authorities could not pursue fraud while preserving children’s access to services. She said officials were using a sledgehammer when a scalpel was needed and called for an approach that would not obliterate care for families.
One Georgia foster mother has already been told that her son’s provider may have to stop treating him, according to the Georgia Recorder. The child, who is nearly 3 years old, had begun making progress.
Kelsey Bennett, another family advocate with the Autism Families Alliance, said reforms intended to improve care, increase efficiency and prevent abuse had broad support. However, she argued that something had gone seriously wrong when those measures made autism care harder to obtain.
"No one wants to eliminate waste, fraud and abuse more than the providers who dedicate their lives to caring for these children," Bennett told Fox News Digital. "Every taxpayer dollar should go toward helping the people it was intended to serve."
Bennett urged Georgia lawmakers to include Medicaid managed care companies and autism care providers in discussions about the cuts. She said listening to people providing services every day could help officials improve efficiency without placing access to care in danger.
"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," Bennett said.
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