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From #MeToo to Maine? Dem experts weigh in on how Platner’s rise tests party standards: ‘Pulling the plug’

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Maine Democratic Senate candidate Graham Platner’s scandal-plagued rise is causing rifts within the Democratic Party, and several Democratic strategists who spoke to Fox News Digital warned of the long-term implications of the party embracing him.
«Anyone paying attention to the intersection of culture and politics knows that my party pushed #MeToo well beyond the bounds of common sense long before Graham Platner’s rise,» Michael LaRosa, former press secretary to first lady Jill Biden, said about whether the #MeToo movement rings hollow within the party now that top Democrats have rallied behind Platner.
«But the reflexive partisan instinct to circle the wagons around him is the political equivalent of pulling the plug on whatever credibility Democrats had left as the self-appointed champions of women.»
«If the standards disappear the moment they’re politically inconvenient, they were never standards at all.»
JONATHAN TURLEY: WHEN JOURNALISTS WHINE ABOUT #METOO, THEY DON’T MEAN PLATNER, TOO
Graham Platner, Democratic Senate candidate for Maine, speaks at a primary election night event at the Blue Hill YMCA in Blue Hill, Maine, on June 9, 2026. Platner won the party’s Senate primary after a campaign marked by accusations of past misbehavior and voter concerns. (Graeme Sloan/Bloomberg via Getty Images)
Former adviser to President Bill Clinton and Democratic strategist Doug Schoen argued that Democrats are choosing power and Senate control over serious concerns about Platner’s past, and that could hurt them in 2028.
«In the short term, for some Democrats, those on the progressive left, it’s the right decision, a practical decision,» Schoen said. «To me, it’s a very sad one and certainly undermines the moral legitimacy of the Democratic Party as a whole.»
«Certainly, I think they’ve left themselves vulnerable vis-à-vis Platner’s extreme left-wing positions, his toxicity as a person, the issues with relationships, arguably lying about his Nazi tattoo,» Schoen said. «I certainly think this creates issues for the Democrats where none needed to exist.»
Platner has denied allegations from former girlfriends who told The New York Times that he discussed rape fantasies, drank heavily and had violent episodes, while also facing mounting criticism over sexually explicit messages allegedly sent to women shortly after getting married, a Nazi-linked tattoo and online comments mocking a Purple Heart veteran.
Despite new controversies emerging days before Maine’s Democratic Senate primary, Graham Platner won with more primary votes than any Democrat in state history.
Democratic strategist Mally Smith told Fox News Digital he doesn’t believe that the Platner campaign is necessarily the «death» of the #MeToo movement, but that Democrats who have «more fully embraced» his campaign are «going to have some trouble when it comes to making the case on the Epstein files or any general claims of believe all women.»
«So maybe Democrats don’t have the advantage on the issue anymore, but I would say that it’s not like Republicans have an advantage either,» Smith added. «I think voters are just gonna say, well, both parties are willing to live with the baggage of their candidates.»
Looking ahead to 2028, LaRosa said that Democrats could be haunted by their ties to Platner for years.
«If he wins, you’ll still have to explain why you stood with him,» LaRosa said. «If he loses, you’ll have nothing to show for it except the association. Either way, he’s someone you’ll be answering for.»
Smith explained Platner’s rise by citing voters that are «unhappy with the status quo» to the point where there’s an «element, whether it’s Republican voters supporting President Donald Trump or Democratic voters supporting Graham Platner in Maine, where they say these elites attacking him is actually evidence that he’s on the right track.»
For others, the controversies are still too big for voters to ignore. LaRosa said that voters «reward guts, not willful blindness» when judging a candidate with Nazi imagery tattooed on his chest, adding that the Democratic leaders are lacking that same «courage.»
DEMOCRATS BREAK WITH SCANDAL-PLAGUED GRAHAM PLATNER, WARN OF ‘CIVIL WAR’ IN PARTY

Sen. Bernie Sanders, I-Vt., and Democratic U.S. Senate candidate Graham Platner stood together during a «Fighting Oligarchy» tour stop at the Collins Center for the Arts on the University of Maine campus on May 24, 2026, in Orono, Maine. (Joe Raedle/Getty Images)
«We look pretty vapid, unprincipled and hypocritical to look the other way when it comes to any candidate accused of any level of violence against women just because it is politically inconvenient,» LaRosa said. «Never again should voters trust us or take our moral arguments seriously. Principles only mean something when they’re applied across the board, even when it’s politically uncomfortable.»
For over a decade, Democrats have used the «Nazi» attack line against President Donald Trump, but have nevertheless mostly rallied around Platner, despite the Nazi imagery tattooed on his body for 18 years.
«They’re seeing all of these lunatics, like the guy in Maine…for ten years they’ve been calling me a ‘Nazi,’ and now they have a Nazi running. He’s got a tattoo on him,» President Trump said during a Thursday news conference.
Schoen argued Democrats have now weakened their case against Republican scandals, pointing to Texas Attorney General and Senate candidate Ken Paxton.
«For every criticism that they level at Ken Paxton in Texas, they will be greeted by criticism of Graham Platner in Maine, which to me makes their job more difficult,» Schoen said.
Smith made a similar point, saying both parties are dealing with candidates causing «their own version of heartburn» that can be used against them politically.
Trump-backed Paxton prevailed in the primary against incumbent Sen. John Cornyn, R-Texas, after he was impeached by the Texas House, a federal investigation into allegations that he abused his office to aid a donor and cheating allegations.
LaRosa said the «uncomfortable truth» is that Democrats have reduced Platner to a simple political equation, viewing him as «just another number, another vote, another seat, another data point on a spreadsheet» instead of focusing on whether he is the right person for the job.
PLATNER CONTROVERSIES FUEL SPECULATION ABOUT LITTLE-KNOWN MAINE BALLOT REPLACEMENT PROVISION

Texas Attorney General Ken Paxton speaks during a runoff election night event in Plano, Texas, on May 26, 2026. (Antranik Tavitian/Bloomberg via Getty Images)
November may provide a clearer test, Schoen said. He said Platner’s victory does not mean he shed his political baggage, adding Platner has left the party to grapple with problems «where none needed to exist.»
«With Graham Platner, there are literally immediate, multiple sources of concern that are ongoing, and it isn’t clear to me that he will necessarily survive and succeed,» Schoen said.
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Ultimately, Smith said that Maine voters will be focused on the economy and that concerns about Platner will likely only be a major issue within the state rather than nationwide.
«Voters are unhappy with the economy, and I think most people are going to be voting on whether they believe the economy is better than when Trump was inaugurated, and the answer to that is a resounding no,» Smith said. «So I think as much as news stations like to talk about Graham Platner and what this means for Democrats overall, or vice versa, Ken Paxton and Republicans overall, most voters are not going to think about Graham Platner’s Nazi tattoo outside of Maine. So I think this is more of a localized Maine problem.»
Fox News Digital reached out to the Platner campaign for comment.
democrats elections, the clintons, graham platner, primary results, republicans, maine, democratic party
INTERNACIONAL
What’s old is new again: Trump-style conservative is back as PM of European nation

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ŠKOFJA LOKA, Slovenia: The Republic of Slovenia, the central European nation known for being the birthplace of First Lady Melania Trump and LA Lakers star Luka Dončić, is undergoing a radical shift in politics as the country comes to terms with its new larger-than-life prime minister.
Prime Minister Janez Janša recently scraped together a coalition that did away with the country’s leftist leader, Robert Golob.
In what is his fourth term, Janša has begun what many see as Trump-like policy corrections. He has reversed Golob’s anti-Israel policies by announcing his intent to move the Slovenian embassy to Jerusalem, freezing Slovenia’s recognition of a Palestinian state and revoking a 2025 ban on military trade with Israel.
EUROPE’S ‘GREEN IDEOLOGY’ CLIMATE AGENDA RISKS CRUSHING ITS INDUSTRY, ENVIRONMENT MINISTER WARNS
Right-wing Slovenian Democratic Party (SDS) leader Janez Jansa addresses the media after his investiture vote as Slovenia’s Prime Minister at the National Assembly in Ljubljana on May 22, 2026. (Jure Makovec / AFP via Getty Images)
Janša also believes in strong U.S. relations. During an America 250 event hosted by the U.S. Embassy in Ljubljana, and with the First Lady’s father, Viktor Knavs, in attendance, Janša described how America was the beacon for Slovenian independence. «We imagined America, the United States of America, as the ideal embodiment of that free world… That Slovenia, too, would become the home of the brave in a land of the free.»
Domestically, he says his new government will reverse what he called the Golob government’s «inefficiency» and turn Slovenia into «a country of opportunity, prosperity and justice, where each responsible citizen will feel safe and accepted.»
He has announced plans to reverse many anti-business policies, cut government red tape, support private education and healthcare, reform the pension system, decrease the size of government and invest in infrastructure projects, including a plan to build a second reactor at Slovenia’s Krško nuclear power plant.
Despite some policy disagreements, Janša was a close ally of former Hungarian Prime Minister Viktor Orbán. He has expressed support for Ukraine, traveling to Kyiv during his last term as prime minister in March 2022 with the then-Polish and Czech Prime Ministers in an early showing of EU solidarity against the Russian invasion and he recently returned to Kyiv to mark Ukraine Statehood Day as part of the Ukraine–Southeast Europe Summit.
WHITE HOUSE BLASTS SPANISH GOVERNMENT AS THOUSANDS OF MIGRANTS SURGE FROM MOROCCO, EMERGENCY REQUEST DENIED

File: A sign which reads ‘Welcome to the Hometown of the First Lady’ in Slovenian, is pictured on November 27, 2016 in Sevnica, Slovenia. Born in Slovenia, Melania Trump was raised in the town of Sevnica, by her father, a car salesman, and her mother, a pattern maker at a textile factory. The former model will become the second foreign-born First Lady of the United States when her husband Donald Trump is sworn in as President during a ceremony in Washington DC on January 20, 2017. ( Jack Taylor/Getty Images)
He supports increased military aid to the country and increased sanctions against Russia. And like Orbán, Janša was staunchly anti-immigrant during the huge Europe migration wave in 2015, when «Balkan Route» migrants practically marched through Slovenia on their way to other parts of Europe.
Janša often praises many of President Trump’s immigration policies. Although no reforms have yet made it through the Slovenian parliament, shortly after taking office, Janša joined 18 other EU leaders in signing a letter calling for «a fundamental change in immigration policy» and practice.
They called for reducing irregular migration, combatting human smuggling more effectively, increasing deportations, and strengthening cooperation with third countries. Janša said Slovenia is «finally joining» other countries calling for these reforms, writing, «The end is approaching for social tourism, overlooked people smuggling and the importation of voters for the European left.»
‘YOU’RE DESTROYING YOUR COUNTRIES’: IS EUROPE FINALLY HEEDING TRUMP’S WARNING ON ILLEGAL IMMIGRATION?
And, like Trump, Janša has his critics. He has been called «the greatest threat to Slovenia’s sovereignty and democracy.»
An aggressive user of X, where he comments on politics and criticizes his opponents in late night posting sprees, Janša has had battles with the country’s media, with many accusing him of undermining its independence.
Janša has also served time in jail, having been convicted and imprisoned in a case he called politically motivated.
Now serving a fourth non-consecutive term as prime minister— or predsednik vlade—he strangely lost the election that eventually put him back in office in June.
On two occasions, Janša and his party lost an election, yet he still became the prime minister. Think of it as losing the popular vote yet winning the Electoral College.

FILE: Residents of Sevnica, hometown of Melania Trump, wife of Republican presidential elect Donald Trump, hang a US flag as they celebrate the victory of Donald Trump in the race for the White House in Sevnica, Slovenia on November 9, 2016. Republican Donald Trump has won the US presidency with at least 290 electoral votes, securing more than the 270 he needed to succeed Barack Obama. (Jure Makovec/AFP Via Getty Images)
Slovenes went to the polls on March 22 after a tumultuous four-year term for then-Prime Minister Robert Golob and his far-left coalition partners. Polls that had initially forecast a landslide victory for Janša tightened quickly in the run-up to election day. Golob’s Gibanje Svoboda, or Freedom Movement, party would «win» by taking 29 seats of the 90-seat legislature with 28.7% of the vote. That was a net loss of 12 seats from the 41 seats and 34.5% of the vote the party won in 2022.
Janša’s Slovenska demokratska stranka, or Slovenian Democratic Party, the party he has led since 1993, took 28 seats with 27.9% of the vote. The same 29-28 outcome as in 2008, when Janša also «lost» yet was able to form a governing coalition.
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After a month of trying, Golob was unable to form a new ruling coalition. Slovenian President Nataša Pirc Musar said she would not nominate anyone for prime minister as no one was able to get the 46 votes needed in Parliament.
Enter Janša, who many analysts call a master coalition builder. After two weeks of discussions, his future government would end up receiving 51 votes in a secret ballot of the National Assembly: 48 from his coalition and their partners, two from the representatives of the Italian and Hungarian minorities in Slovenia… and, surprisingly, one from an anonymous member of the opposition.

Then Slovenia’s opposition leader and nationalist former Prime Minister Janez Jansa and his wife Urska cast their ballots at a polling station during the general election in Arnace on March 22, 2026. ( Jure Makovec / AFP via Getty Images)
Janša has been involved in Slovenian politics since before there was an independent Slovenia. In 1988, he was arrested, tried «in camera» in a military court, and imprisoned by the Yugoslav People’s Army in what became known as the «JBTZ affair». He was alleged to have shared military documents with journalists. After public outcry at the time, Janša was released after serving six months of an 18-month sentence.
In 1989, Janša helped form the Slovenian Democratic Union, one of the first opposition parties in the then-Socialist Republic of Slovenia. After Slovenia’s first free elections in May 1990, Janša was named minister of defense, helping lead Slovenia’s 10-day war of independence against Yugoslavia in the summer of 1991.
In June 2013, the Ljubljana District Court ruled Janša and two others had sought about €2million (about $2.3 million) from a Finnish firm, Patria, to help it win a 2006 military supply contract. Janša was sentenced to 2 years in the same prison in which he began his 1988 imprisonment. He called the case politically motivated and, again, he was released after serving 6 months. The conviction was unanimously overturned by the Constitutional Court in April 2015.
Janša is expected to come to the U.S. to address the United Nations General Assembly in September. It is not known if he will meet with President Trump and the First Lady.
europe, israel, immigration, donald trump, ukraine, the balkans
INTERNACIONAL
Ceuta y el bulo que metió a 60.000 personas en el mar

¿Y si lo que acabamos de vivir en Ceuta es, sobre todo, un fenómeno de redes sociales?
Conviene empezar por explicar qué es Ceuta, porque buena parte de la confusión de estos días nace de imaginarla como un puesto fronterizo cualquiera. Ceuta es una ciudad española situada en la costa norte de África, frente a Gibraltar, separada de la Península por los catorce kilómetros del Estrecho. Es española desde 1580, más de dos siglos antes de que existieran los Estados Unidos. Tiene 18,5 kilómetros cuadrados, unos 84.000 habitantes y estatuto de ciudad autónoma. Junto con Melilla constituye la única frontera terrestre entre la Unión Europea y el continente africano, y esa condición la convierte en el punto exacto donde la presión migratoria de todo un continente se concentra en unos pocos kilómetros de valla y una playa, la del Tarajal, con su espigón que se adentra en el mar marcando la línea entre Marruecos y España.
Esa frontera tiene historia trágica. En febrero de 2014 murieron ahogadas 14 personas a pocos metros de la playa del Tarajal, en parte por el pánico de la multitud en el agua. En mayo de 2021, en plena crisis diplomática con Rabat por la acogida en España del líder del Frente Polisario, Marruecos relajó los controles y más de 8.000 personas entraron en Ceuta en dos días, obligando a desplegar al Ejército. En junio de 2022, el asalto a la valla de Melilla dejó al menos 23 muertos. La frontera sur funciona desde hace décadas como válvula de presión, y cada episodio ha alimentado la sospecha de manos que mueven los hilos.
Lo de esta semana supera todo lo anterior en un orden de magnitud. Entre el jueves 30 y el viernes 31 de julio entraron en Ceuta entre 50.000 y 60.000 personas en menos de 24 horas, el equivalente al 70% de la población de la ciudad. Trasladado a escala peninsular, sería como si 34 millones de personas entraran en España en un día. El balance es de al menos 57 muertos, con las tareas de búsqueda todavía en curso. La mayoría se ahogó intentando bordear a nado el espigón del Tarajal, de noche, vestidos, atrapados entre las olas y las rocas de la escollera mientras miles de personas entraban al agua a la vez. Otros murieron aplastados en los intentos masivos de cruzar las vallas. El Gobierno desplegó al Ejército, Pedro Sánchez viajó a Ceuta, calificó lo ocurrido de ataque a la integridad territorial de España y anunció un sistema de boyas junto al espigón para impedir nuevos cruces a nado.
La pregunta obligada es qué fuerza consigue que decenas de miles de personas asuman ese riesgo a la vez. Y aquí es donde la explicación más sólida resulta ser la menos conspirativa.
El 8 de julio el Tribunal Supremo dictaminó que las devoluciones en caliente no se aplican a quienes llegan por mar, que deben pasar por un procedimiento formal de devolución. En redes, ese matiz jurídico se transformó en otra cosa: España ha abierto la frontera y si entras a nado no te pueden devolver. El bulo corrió por WhatsApp, TikTok, Instagram y Telegram. Circularon mapas con la ruta a nado desde Castillejos, en Facebook llegaron a venderse trajes de neopreno para el cruce y los primeros vídeos de jóvenes celebrando en la playa hicieron el resto. Adolescentes de 16 y 17 años contaron después que se habían enterado por las redes y que habían pasado cinco horas nadando.
El patrón es conocido. En 2019, más de dos millones de personas se apuntaron en Facebook a asaltar el Área 51 y varios miles se presentaron de verdad en el desierto de Nevada. En 2012, una invitación de cumpleaños mal configurada en Facebook arrastró a miles de jóvenes al pueblo holandés de Haren, que acabó arrasado. En 2021, un foro de Reddit coordinó a millones de pequeños inversores para disparar la acción de GameStop y poner contra las cuerdas a varios fondos de Wall Street. Ese mismo año, 25.000 jóvenes se juntaron en un macrobotellón en Madrid convocados por redes. Ninguno de estos episodios tuvo un organizador central. Todos siguieron la misma secuencia: un mensaje simple, una promesa creíble, vídeos de los primeros que lo consiguen y una avalancha. La diferencia es que en Ceuta la promesa exigía meterse al mar.
La noche del jueves lo vi en directo. En Horizonte, el programa de Iker Jiménez en el que colaboro, las cámaras mostraban cómo centenares de personas llegaban a Ceuta y al poco rato emprendían el camino de vuelta. Entraban, comprobaban que la promesa era falsa, que allí les esperaba frío, hambre y un ejército desplegado en lugar de un pasaje a la Península, y regresaban. La ola completa, subida y bajada, se veía en tiempo real. Una operación orquestada para desestabilizar habría intentado que la gente se quedara. El regreso lo aceleraron el despliegue militar y el acuerdo con Marruecos para las repatriaciones, y queda pendiente el problema serio de los menores no acompañados que sí permanecen. Pero el motor del retorno fue el mismo que el de la ida: los canales que crearon el efecto llamada empezaron a difundir el efecto regreso, con mensajes de quienes ya volvían advirtiendo a los suyos de que ni lo intentaran.
Hay además un detalle que desmonta la tesis de una marcha nacionalista para reclamar Ceuta: en las imágenes faltan banderas marroquíes y camisetas de la selección. Se ven jóvenes saltando la valla con la camiseta de Messi. Quien va a reconquistar un territorio lleva su bandera. Quien busca un futuro lleva la camiseta de su ídolo.
Esta explicación tiene una virtud: se sostiene sola. El socialismo español sobra como organizador, sobra el rey de Marruecos, sobran Estados Unidos e Israel. La pólvora es real. Es el paro juvenil y la falta de horizontes en Marruecos, y es también lo que cada joven marroquí ve a diario en su teléfono: los marroquíes son la mayor comunidad extranjera de España, con cerca de 900.000 residentes legales, y muchos de sus compatriotas cobran el Ingreso Mínimo Vital y el paro viviendo mejor que ellos, o trabajan y ganan en un mes lo que en casa cuesta meses ganar. Esto fue una búsqueda personal de un futuro mejor. El socialismo español sobra como conspirador y aparece como imán: el efecto llamada del Estado del bienestar, viralizado. La chispa fue una sentencia mal entendida, millones de teléfonos y la promesa de una vida mejor a cinco horas nadando.
Marruecos merece escrutinio de todas formas. Un país que intercepta a cinco nadadores con neopreno un día cualquiera y deja pasar a 60.000 otro día ejerce política también por omisión. En 2021 relajó los controles en plena crisis diplomática y esta vez su gendarmería tardó en reaccionar. España respalda además con cerca de 340 millones de euros públicos la desaladora de Casablanca y mantiene otras líneas de cooperación, de modo que condicionar ese apoyo financiero a resultados verificables en frontera sigue siendo razonable aunque el fenómeno haya sido viral. Pero hay una diferencia entre tolerar y organizar, y a día de hoy no existen pruebas públicas de organización estatal.
La conclusión es incómoda porque un fenómeno viral es en cierto sentido más grave que una maniobra de Estado. Con un Estado se negocia, se firman acuerdos, se condicionan fondos. Contra un rumor capaz de meter a 60.000 personas al mar en una noche solo funcionan dos cosas: capacidad real de respuesta en la frontera y desmentidos oficiales tan virales como los bulos. Un bulo llenó el agua de gente y el agua devolvió 57 cuerpos. La próxima avalancha no la decidirá Rabat. La decidirá un vídeo de TikTok.
Immigration,Europe,Asylum / Immigration / Refugees
INTERNACIONAL
Latest fraud scheme targets taxpayer-funded autism therapy boom

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Applied Behavior Analysis therapy is a lifeline for hundreds of thousands of American families — helping children with autism develop communication, social and daily living skills.
But as Medicaid spending on the autism therapy has exploded into the billions and with fraud on the rise, a partisan divide is emerging over how states should handle public assistance programs for the ballooning treatment option.
Republican-led states like Florida have prioritized fraud enforcement and tighter oversight, while debates in states like Georgia have centered on reimbursement rates and preserving access to care. The scrutiny comes as the Trump administration has made it a focus of his second term to eliminate fraud, waste and abuse across federal programs, including Medicaid, a central policy priority.
Supporters of stronger oversight argue that every dollar lost to fraud is money that cannot be used to provide care for children and families who depend on Medicaid-funded autism therapy.
Applied Behavior Analysis (ABA) therapy helps children with autism build communication, social and daily living skills through structured, one-on-one sessions. (iStock)
TRUMP ADMIN PAUSING OVER $1B IN MEDICAID PAYMENTS TO MINNESOTA, CALIFORNIA OVER FRAUD, COMPLIANCE CONCERNS
According to Department of Health and Human Services (HHS) Medicaid provider spending data, Medicaid paid more than $5.15 billion between 2018 and 2024 under one of the primary billing codes used for Applied Behavior Analysis (ABA) therapy.
Three providers received roughly $685 million in Medicaid reimbursements during that period.
ABA therapy is one of the most common treatments for children with autism, using structured, one-on-one sessions to build communication, social and daily living skills.
Much of that therapy is delivered by Registered Behavior Technicians (RBTs), entry-level workers who complete a 40-hour training program and work under the supervision of Board Certified Behavior Analysts, whose job it is to design and oversee treatment plans.
MEDICAID FRAUD FEARS GROW AMID MASSIVE RED STATE BILLING SPIKE IN SECTOR THAT ALSO PLAGUED MINNESOTA

Republicans have argued that eliminating fraud, waste and abuse in Medicaid should be a priority before considering broader changes to the program, saying improper payments divert taxpayer dollars from vulnerable Americans who depend on the safety net. (Leigh Vogel/Getty Images for Caring Across Generations)
As Medicaid spending on ABA therapy has surged, so has scrutiny over how taxpayer dollars are being spent.
In May, federal prosecutors charged two Minnesota autism clinic operators with allegedly billing Medicaid $46.6 million for services prosecutors say were unnecessary or never provided, including claims tied to children with allegedly fraudulent autism diagnoses.
Earlier this year, another Minnesota woman pleaded guilty in a separate $14 million Medicaid autism fraud scheme.
Investigations by The Wall Street Journal and The New York Times have also documented allegations that some providers billed for services that were never provided, inflated therapy hours and aggressively expanded as Medicaid spending surged.
MINNESOTA FRAUD SUSPECT SKIPS COURT, FORFEITS BOND, THROWING $11M MEDICAID CASE INTO DOUBT

The Trump administration has made eliminating fraud, waste and abuse in Medicaid a central priority, calling on states to tighten oversight and remove fraudulent providers from the program. (Andrew Harnik/Getty Images)
The Medicaid data also identifies examples of providers receiving unusually large reimbursements under the ABA billing code, including some claims that equate to hundreds of dollars per minute of therapy based on a standard 15-minute billing unit. The data alone does not explain why those reimbursements were so high, and billing experts say unusually large payments can reflect a variety of factors, including claim adjustments or other administrative processes.
The Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees Medicaid in partnership with states, told Fox News Digital it has observed «significant growth» in Medicaid spending on ABA therapy in recent years.
«While access to medically necessary services remains a priority, rapid program growth also underscores the importance of ensuring services are clinically appropriate, delivered by qualified providers, and supported by strong program integrity safeguards,» a CMS spokesperson said.
As concerns over fraud have grown, states have responded differently.
Florida says it recovered more than $72 million in improper Medicaid payments over the past year and prevented hundreds of behavior analysts from participating in Medicaid because of documented fraud concerns.
Last month, Republican Florida Gov. Ron DeSantis announced a statewide Medicaid Integrity Initiative to strengthen provider screening, enhance fraud detection and increase oversight aimed at protecting taxpayer dollars.
While Florida has focused on strengthening fraud enforcement, Georgia lawmakers have focused on reimbursement rates. Lawmakers recently questioned a Medicaid managed care organization’s decision to reduce ABA reimbursement rates by 20%, even as industry representatives testified that use of autism therapy services had increased by more than 300% in recent years.
The debate reflects the difficult balance between rooting out fraud and preserving access to a therapy that many families say has been life-changing for children with autism.
health care, health care senate, autism, childrens health, politics
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