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Funerals, beauty queens and bombs: The Ukrainian city that won’t let Putin win

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LVIV, Ukraine — As Kyiv takes a massive hit from Russia, another city seeks to carry on amid war. Four years into Russia’s war, the western Ukrainian city of Lviv is trying to master something impossible: how to live normally while surrounded by death.

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At 11:30 a.m., the city stops.

Cars freeze in the middle of the street. Pedestrians pause on sidewalks. In the center of town, underneath the tall clock tower that rises above city hall, people bow their heads in silence as another military funeral convoy passes through the streets.

«It happens one to five times a day,» a local resident says quietly.

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The war feels far from Lviv, until suddenly it doesn’t.

UKRAINE’S BATTLEFIELD IS TRANSFORMING THE FUTURE OF NATO

Residents stop in silence as a military funeral convoy carrying a fallen Ukrainian soldier passes through central Lviv near City Hall. (Efrat Lachter/Fox News Digital)

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The city of roughly one million people sits near the Polish border, hundreds of miles from the brutal front lines in eastern Ukraine. But Russian drones and missiles still hit here. Air raid sirens interrupt coffee dates and children’s soccer games. Funeral processions cut through wedding traffic. Entire neighborhoods live between moments of beauty and grief.

«We lost approximately 2,000 citizens of Lviv,» Mayor Andriy Sadovyi told Fox News Digital during an interview at city hall. «It is a very huge price which we pay to our independence, to our democracy.»

Sadovyi has led the city for nearly two decades, except for a brief presidential run. Inside his office overlooking the historic center, he proudly points to the terrace where he has hosted world leaders and celebrities, including actor Tom Cruise. At one point, a large well-fed cat jumps onto his desk.

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«This is my deputy,» Sadovyi jokes. The cat, he explains proudly, has become something of a city mascot. «He’s tough like a Ukrainian.»

But beneath the humor is exhaustion. Sadovyi says he realized at the beginning of the war that Lviv had a special responsibility. It was close enough to Europe to remain functioning, but close enough to war to understand what was at stake.

His answer was what he calls the «Unbroken» project: a sprawling rehabilitation and innovation effort aimed at helping Ukraine survive physically and psychologically.

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The city built rehabilitation centers for wounded soldiers and civilians arriving from across the country, treating amputees, burn victims and trauma patients. Sadovyi says the municipality also dedicated 20% of its budget to supporting defense technology companies developing military solutions for the war effort.

«Every family in this city was affected by war,» he says. «We need to be strong. We need to survive. I’m building what is needed for that.»

‘A NEW KIND OF WAR’: INSIDE UKRAINE’S HIDDEN FACTORIES MASS-PRODUCING COMBAT DRONES

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Shooting range in Lviv, Ukraine.

A shooting instructor stands inside a civilian training range in Lviv, where residents learn weapons handling, survival skills and emergency preparedness amid the ongoing war. (Efrat Lachter/Fox News Digital)

Yet survival in Lviv is not only about weapons or hospitals. It is also about convincing people not to give up on life itself.

«People are afraid to come here,» Sadovyi says. «But we need them to come.»

One of the city’s newest projects reflects that mentality. Part school, part shooting range, part patriotic training center, it was designed to prepare civilians for a country where war has become everyday reality.

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Inside one classroom, dozens of teenage girls sit listening to instructors explain emergency survival skills. Upstairs, at the indoor shooting range, instructor Vitaliy proudly shows off rows of American-made weapons including AR-15 style rifles and pistols.

«It’s not as big as ranges in the United States,» he says apologetically.

On the wall hangs a shredded image of Soviet founder Vladimir Lenin, riddled with bullet holes from target practice.

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Vitaliy laughs when asked about Russian President Vladimir Putin posters.

«We ran out,» he jokes. «They’re too popular. We can’t keep them.»

On the terrace outside, two wounded veterans practice archery.

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One sits in a wheelchair after losing both legs in the war. Another leans on a cane. Both have become competitive athletes through rehabilitation programs.

NATO ALLY POLAND WARNS RUSSIA, BELARUS PUSHING ILLEGAL MIGRANTS TOWARD ALLIANCE — AND THE US

Armoury in Lviv.

Weapons and helmets at a local center in Lviv where locals practice shooting among other things. (Efrat Lachter/Fox News Digital.)

One proudly explains he won a silver medal during a national contest. The other recently took gold and is now preparing for an international championship. Neither wants to talk much about what happened to them during combat.

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Their therapy now is sport.

Down the road, another funeral begins. A military convoy carrying the body of a 32-year-old soldier drives slowly through the city center until it arrives at the cemetery.

The city’s military cemetery filled so quickly that officials recently had to open a new burial ground just weeks ago. Already, rows of fresh graves stretch across the hillside, above them blue-and-yellow flags and photographs of young men and women smiling back from before the war.

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The grieving brother at the funeral says the fallen soldier never had time to start his own family.

Around him, families kneel beside the earth.

And still, life continues.

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Children go to school. Mothers rush to work. Cafés remain packed. Street musicians perform in the old town square.

That same evening, inside the Lviv Theater of Opera and Ballet, hundreds gather for the «Miss Lviv» beauty pageant.

Young women dressed in glittering gowns pose beneath bright stage lights while music echoes through the theater. The audience is overwhelmingly female. Many of the men still in the city work in defense industries or hold exemptions from military service.

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POLAND SEEKS ANSWERS AFTER PENTAGON SCRAPS PLANNED US ARMORED BRIGADE ROTATION

The contrast feels surreal only hours after attending a military burial.

But for many residents, events like these are an act of resistance.

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«We are trying to keep life going,» the reigning Miss Lviv says backstage before crowning the next winner. «I want the war to stop.»

One of her friends explains why gatherings like this matter.

Miss Lviv beauty contest

The reigning Miss Lviv during the «Miss Lviv» beauty pageant in Lviv, as residents attempt to preserve normal life four years into the war. (Efrat Lachter/Fox News Digital)

«These are difficult times,» she says. «Doing normal things like this gives us a reason to dress up and enjoy ourselves.»

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Nobody here believes anymore that peace can come in 24 hours. But many still hope that President Trump and the U.S. can help bring the war to an end.

By the time evening arrives, air raid sirens once again cut through the city.

At outdoor cafés, people barely react at first.

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Miss Lviv beauty contest.

Contestants participate in the «Miss Lviv» beauty pageant in Lviv, as residents attempt to preserve normal life amid the ongoing war.

‘WRITTEN IN OUR DNA’: POLISH PILOTS WHO REMEMBER SOVIET RULE PREPARE FOR AMERICA’S MOST LETHAL FIGHTER JET

Parents continue watching children play near fountains. Young couples finish drinks on restaurant terraces. Residents wait to hear whether the threat is «only» drones or actual missiles before deciding whether to move toward one of the hundreds of shelters spread throughout the city.

That frustration increasingly extends beyond the battlefield itself. Speaking to Fox News Digital while the latest wave of Russian strikes battered Ukrainian cities overnight, Ukraine’s Ambassador to the United Nations Andriy Melnyk warned that the war was becoming even more dangerous for civilians.

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Melnyk, a native of Lviv, described the massive Russian assault between Saturday and Sunday as «the worst and the most devastating Russian attack on the capital since the beginning of the large-scale invasion.»

Ukraine’s Ambassador to the United Nations Andriy Melnyk

Andriy Melnyk, Ukraine’s ambassador to the United Nations and a native of Lviv, speaks to Fox News Digital on May 26, 2026, warning that Russia’s latest assault was «the worst and the most devastating Russian attack on the capital since the beginning of the large-scale invasion.» (Efrat Lachter/ Fox News Digital)

Even members of his own family in Kyiv, he said, are now considering temporarily leaving the city because «it becomes unbearable to stay.»

In Lviv, residents repeatedly ask to remind the world that the war is still intensifying, not fading into the background. Melnyk called on the United States and European allies to take «bold actions» to pressure Russian President Vladimir Putin and urged Western countries to provide additional air defense systems capable of intercepting ballistic missiles and drones targeting civilians.

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He also criticized the United Nations for failing to stop the war, arguing that Russia’s veto power had left the Security Council effectively paralyzed.

female soldiers Ukraine

Ukrainian female soldiers are seen before heading to the frontline as Ukrainian displaced civilians continue to swarm around the train station to flee due to ongoing Russian attacks, in Lviv, Ukraine on March 24, 2022.  (Photo by Metin Aktas/Anadolu Agency via Getty Images)

On the overnight train leaving Lviv, most passengers are women. Border guards spend long minutes questioning the few men onboard, making sure they are not trying to escape mandatory military service. 

The exhaustion is visible everywhere. Still, Sadovyi is full of hope.

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«This city will have a great future,» he says confidently.

He believes the world will eventually come to Lviv not only to rebuild, but to learn.

CLICK HERE TO DOWNLOAD THE FOX NEWS APP

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«To learn how to be unbroken,» he says.

Because, he warns, what happened to Ukraine could happen elsewhere too.

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ukraine, wars, vladimir putin, military, technology

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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. 

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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

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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.»

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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

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Melanie Trump poster in Slovenia

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.»

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‘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.

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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.

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Slovenia Trump

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.

MELANIA TRUMP HELPS REUNITE FIFTH GROUP OF UKRAINIAN, RUSSIAN CHILDREN WITH FAMILIES

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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.

Janez Jansa

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.

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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.

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europe, israel, immigration, donald trump, ukraine, the balkans

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Ceuta y el bulo que metió a 60.000 personas en el mar

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Entre el jueves y el viernes, entraron en Ceuta entre 50.000 y 60.000 personas en menos de 24 horas

¿Y si lo que acabamos de vivir en Ceuta es, sobre todo, un fenómeno de redes sociales?

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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.

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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.

Más de 60 personas murieron al intentar cruzar a nado a España (REUTERS/Jon Nazca)
Más de 60 personas murieron al intentar cruzar a nado a España (REUTERS/Jon Nazca)

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.

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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.

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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

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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.

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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.

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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.

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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.

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MEDICAID FRAUD FEARS GROW AMID MASSIVE RED STATE BILLING SPIKE IN SECTOR THAT ALSO PLAGUED MINNESOTA

A protestor holds a sign at protect Medicaid lights up Capitol amid budget showdown, on May 07, 2025 in Washington, DC.

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.

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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

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Trump and RFK Jr. at White House

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.

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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.

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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.

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health care, health care senate, autism, childrens health, politics

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