WHAT YOU NEED TO KNOW
- Amerigroup is cutting Medicaid payments 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 reimbursement cuts.
- The Autism Families Alliance supports prosecuting Medicaid fraud but warns broad enforcement could restrict legitimate autism care.
- Advocates are urging Georgia lawmakers, insurers and providers to seek efficiency without jeopardizing children’s access to therapy.
American autism care providers who supported the Trump administration’s crackdown on Medicaid fraud are warning that the campaign could carry damaging unintended consequences. In Georgia, reimbursement cuts have placed therapy for foster children with autism at risk.
The Autism Families Alliance, a national advocacy organization supporting Applied Behavior Analysis providers and families, says federal and state efforts to fight fraud have gone too far. The group warns that many Georgia foster children with autism could lose needed care.
The immediate concern centers on Amerigroup, the insurer that covers Georgia’s foster children through Medicaid. Amerigroup is cutting payments to autism therapy providers by 30%, raising questions about whether those providers can afford to continue treating foster children.
Providers say many foster families cannot simply move children to another insurer. That leaves them particularly exposed if clinics close, reduce services or stop accepting foster children because of the lower reimbursement.
Taylor Sanders, a family advocate at the Autism Families Alliance, said the cuts could reduce access for children who need help learning safety and everyday skills. She also pointed to children with aggressive or challenging behaviors who rely on providers for specialized services.
"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," Sanders told Fox News Digital.
Sanders said 75% of clinics will have to close their doors or stop serving foster children because of the cuts. Such an outcome would sharply narrow the number of providers available to a population already facing limited insurance options.
Regular therapy helps foster children with autism develop everyday abilities, according to Sanders. She warned that losing this support could cause setbacks and said failing to teach school skills through early intervention or at an early age would prove more costly later.
The Autism Families Alliance supported the Trump administration’s Medicaid fraud crackdown in August. The organization argued that the alleged theft of millions in federal funding had harmed taxpayers and children with autism who depend on Medicaid supported services.
Some states, including Georgia, have also moved to increase oversight of autism services. The alliance supported eliminating fraud and prosecuting suspected criminals, while cautioning that broad enforcement efforts could create barriers for legitimate providers and families seeking care.
The group now says Georgia foster families are facing the exact risk it previously raised. Sanders said fraudulent conduct should be prosecuted to the highest extent of the law, but questioned why officials could not combat fraud while preserving children’s access to services.
Sanders characterized the response as an overly blunt approach, comparing it to using a sledgehammer when a scalpel was needed. She urged officials to pursue enforcement without obliterating care for families that depend on autism services.
The Georgia Recorder reported that one foster mother had already been told her son’s provider might have to stop treating him. The child, who is nearly 3 years old, had begun making progress before the family received that warning.
"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.
Bennett said providers who care for children also want to eliminate waste, fraud and abuse so taxpayer money reaches its intended recipients. She argued that Georgia cannot repair the system by making assistance harder to obtain for vulnerable children.
Bennett urged Georgia lawmakers to bring Medicaid managed care companies and autism providers into the discussion. She said listening to people working directly with children could help officials improve efficiency without endangering access to care.
Children with autism in foster care already face substantial challenges, Bennett said, and their families should not have to fear that essential treatment will suddenly disappear. She called on Georgia leaders to address the cuts and prevent children from bearing the cost of efforts to save money.
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