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
INTERNACIONAL
Los bloqueos por el alza de combustibles dejan seis agentes heridos y varios arrestos en Guatemala
La Policía Nacional Civil (PNC) confirmó que seis agentes resultaron heridos durante el desalojo de un bloqueo el viernes 11 de septiembre, en el kilómetro 168 de la ruta a Cuyotenango, Suchitepéquez, en una jornada de protestas contra el aumento de los combustibles que también dejó vehículos incendiados en Zacapa y cortes en varios departamentos de Guatemala.
Un cierre continuaba activo el sábado 12 de septiembre a las 06:45 en el kilómetro 225 de la ruta departamental QUE-03, en la aldea Santo Domingo, Colomba Costa Cuca. El bloqueo había comenzado cuatro minutos antes, afectaba ambos sentidos de circulación y era el único punto cerrado en el reporte matutino de la Dirección General de Protección y Seguridad Vial (Provial); las demás rutas figuraban habilitadas.
El policía Ronal Gavino Morales Chávez sufrió un disparo en el estómago y fue trasladado en helicóptero a un centro asistencial de la Ciudad de Guatemala, después de ser estabilizado en el Instituto Guatemalteco de Seguridad Social de Mazatenango. Los otros cinco efectivos padecieron lesiones por explosiones de morteros, el impacto de una piedra en el cráneo y golpes en distintas partes del cuerpo.
La corporación indicó que sus Fuerzas Antidisturbios despejaron más del 90% de los puntos bloqueados en el país. El despliegue respondió a una orden de la Corte de Constitucionalidad para liberar las rutas con apoyo del Ministerio de Gobernación y el Ejército.
Dos focos de conflicto en Zacapa y Villa Nueva
Los incidentes persistían al cierre de la jornada en sectores de Zacapa y Villa Nueva, donde la PNC afirmó haber detectado la presencia de pandillas y estructuras del crimen organizado dentro de las manifestaciones. La institución acusó a esos grupos de usar a mujeres, adultos mayores y niños como escudos humanos.
La fuerza de seguridad solicitó la intervención de la Procuraduría de los Derechos Humanos y de la Procuraduría General de la Nación para proteger las garantías de los menores y las mujeres presentes en las zonas de conflicto. También pidió a los habitantes de los lugares donde continuaban los enfrentamientos que permanecieran en sus hogares mientras avanzaba el operativo.
“Atentar contra la paz en presencia de la niñez guatemalteca es un acto criminal que no quedará impune”, advirtió la policía. La institución requirió denuncias anónimas sobre actividades delictivas, instigación o presencia de personas infiltradas.
La PNC señaló que, con base en el artículo 257 del Código Procesal Penal, detendría en flagrancia a quienes obstruyeran las vías. Los vehículos y camiones utilizados deliberadamente para bloquear carreteras serían puestos a disposición de los tribunales para su comiso.
“Los promotores e instigadores de estos ataques violentos están debidamente perfilados e individualizados y enfrentarán todo el peso de la ley”, sostuvo la corporación.
Durante el operativo en Cuyotenango, las autoridades detuvieron a Armando Constancia Martínez, a quien le decomisaron piedras, hondas, morteros y otros objetos presuntamente utilizados para agredir a los agentes. El arresto se sumó a cuatro capturas previas por disturbios en San Miguel Petapa y Suchitepéquez.
En la zona cinco de Mixco, sobre la calzada San Juan, agentes de la comisaría 16 arrestaron a Juan “N”, de 44 años, y Joseline “N”, de 29, cuando arrojaban objetos contundentes contra policías que buscaban despejar la cuarta avenida.
Otros dos hombres fueron capturados en el kilómetro 19,5 de la ruta al Pacífico. William “N”, de 33 años, y Hugo “N”, de 28, estaban en un bloqueo que reunía a 150 personas, donde también se registró el lanzamiento de piedras contra los efectivos de seguridad.
La presencia policial fue reforzada en la colonia Bethania, el Anillo Periférico, Villa Nueva, la ruta al Atlántico y los sectores de Río Hondo y Zacapa, que concentraron algunos de los cierres más prolongados.
Camiones incendiados y reclamo de estado de excepción
La Cámara Guatemalteca de Transporte de Carga condenó los hechos de violencia, vandalismo y destrucción registrados durante las protestas, con especial referencia a la quema de vehículos y camiones de transporte pesado en la aldea Santa Cruz, en el kilómetro 124 de Zacapa.
“El derecho a manifestar nunca puede convertirse en una licencia para delinquir”, expresó la organización. El gremio sostuvo que ninguna causa justifica la destrucción de propiedad privada, las agresiones contra trabajadores ni la interrupción forzada de las principales vías de comunicación.
La cámara exigió al Gobierno de Guatemala el restablecimiento inmediato del orden y de la libre circulación en la carretera CA-9 y en todos los sectores afectados por bloqueos violentos. También reclamó al Ministerio Público una persecución penal inmediata contra los responsables materiales e intelectuales de la destrucción, los incendios de vehículos y las amenazas contra transportistas.
“Solicitamos respetuosamente, pero con absoluta firmeza”, al presidente que evalúe declarar un estado de excepción en los municipios donde la violencia haya superado la capacidad ordinaria de las autoridades, planteó el gremio.
Las movilizaciones surgieron después de que el Congreso de la República aprobara, con trámite de urgencia nacional, un decreto que establece precios máximos de referencia para el diésel y las gasolinas, además de un fondo de compensación para los importadores. Diversos sectores del transporte consideran insuficiente la medida frente al aumento de los combustibles registrado en los últimos meses.
Policía Nacional Civil,detención,seguridad pública
INTERNACIONAL
Blue state governor’s pardon of convicted felon torpedos a major Supreme Court immigration fight
Judge called out for releasing MS-13 murder suspect in California
DHS general counsel James Percival warns of an ‘epidemic of judicial activism’ after a federal judge in California orders the release of an MS-13 murder suspect. Percival argues that individuals wanted for murder must remain in immigration detention during removal proceedings.
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The Supreme Court will no longer hear an oral argument for a case centered on bond rights for noncitizens detained for lengthy periods, ruling the case moot after New York Democratic Gov. Kathy Hochul pardoned a lawfully present Dominican citizen, who pleaded guilty to second-degree assault.
Hochul pardoned Keisy Guerrero Mariano, who is identified in court documents as «Keisy GM,» in late August, effectively killing the Trump administration’s appeal to the Supreme Court arguing that noncitizens, including those with green card status, do not have a legal right to a bond hearing for a prolonged detention if they have committed crimes that are grounds for mandatory deportation.
Hochul, who is staunchly opposed to President Donald Trump’s immigration enforcement crackdown, issued the pardon for Mariano just as the brief was due.
FEDERAL APPEALS COURT COMPARES TRUMP MIGRANT DETENTION POLICY TO JAPANESE AMERICAN INTERNMENT
FILE – New York Democratic Gov. Kathy Hochul pardoned Keisy Guerrero Mariano in late August. (Adam Gray/Bloomberg via Getty Images)
Solicitor General John Sauer agreed Friday that Genalo v. Black is now moot, but said the Trump administration will seek an «alternative vehicle» to challenge the Second Circuit’s 2024 ruling that prolonged immigration detention can trigger a constitutional right to a bond hearing.
Sauer said the administration intends to find another case through which the Supreme Court can resolve the issue during its 2026-27 term.
The lawsuit centered on the challenges of plaintiffs Carol Williams Black, a Jamaican national with lawful standing, and Mariano — both convicted criminals detained by ICE.
APPEALS COURT BLOCKS TRUMP ADMIN FROM HOLDING MIGRANTS WITHOUT BOND FOR OVER 90 DAYS
Mariano was first arrested by Immigration and Customs Enforcement officers in 2020 over a 2015 second-degree assault conviction for which he served time, making him eligible for deportation.
He spent nearly two years in ICE detention, but was released in 2022 due to a nationwide injunction that required the release of detainees because of COVID-19 health risks.
Prior to his release, Judge John P. Cronan of the U.S. District Court for the Southern District of New York denied Mariano’s habeas corpus request in November 2021.
FILE – Mariano was released in 2022 after spending nearly two years in ICE detention. (Getty Images)
But in May 2024, the Second Circuit overruled Cronan’s decision, ruling that the government must grant noncitizens a bond hearing once detention becomes «unreasonably long.» Failure to do so, the court ruled, would violate the Fifth Amendment’s due process clause.
The case was appealed to the Supreme Court, which agreed to hear the case June 15; however, the high court ruled Black’s case moot because he had left the United States and filed a court declaration that he would not be returning to the country.
Black was convicted in New York in 2000 of sexually abusing a minor under the age of 11.
FILE – Following an appeal, the Second Circuit ruled the government must grant noncitizens a bond hearing once detention becomes «unreasonably long.» (Dominic Gwinn/Middle East Images/AFP via Getty Images)
DHS BLASTS MINNESOTA BOARD FOR UNANIMOUSLY PARDONING ILLEGAL IMMIGRANT CONVICTED OF 3 ASSAULTS
Hochul’s decision to issue a pardon to Mariano has garnered fierce criticism from legal experts.
«Pretty wild to fully pardon an aggravated felon to (1) stop the felon from getting deported and (2) stop the Supreme Court from ruling on an issue. (Especially as this litigation has been going on for years),» Eric Wessan, Iowa’s solicitor general, posted on X.
He praised Sauer’s decision to fight back on the Second Circuit’s ruling.
«I wonder how many non-American felons Governors like Hochul will choose to fully pardon and free to avoid them facing consequences for their actions,» Wessan added.
Fox News Digital reached out to Hochul’s office for comment.
kathy hochul, immigrant rights, judiciary, latino, deportation, supreme court
INTERNACIONAL
Abdul El-Sayed touts ‘whole a–’ medical credentials while defending sex changes for children
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Michigan Democratic U.S. Senate candidate Abdul El-Sayed said the government should not restrict sex changes, arguing that «whole a–» doctors like himself should be allowed to make their own determinations for patients’ treatment plans.
The remarks came during El-Sayed’s Friday rally held at Michigan State University, during which the former Detroit Health Department head responded to a student’s question about protecting sex changes. Since launching his campaign, El-Sayed has flaunted that he is a «physician» and, if elected, he would be the first doctor to serve as a Democratic senator in 50 years. However, Fox News Digital previously reported El-Sayed has never held a medical license in Michigan or New York.
«I went to a whole a– medical school, everybody I graduated with also went to whole a– medical school,» El-Sayed said. «And then… they went to whole a– residency. Right? And some of them went to whole a– fellowship. They took whole a– exams to provide whole a– healthcare.»
DEM SENATE HOPEFUL’S ‘PHYSICIAN’ CAMPAIGN PITCH UNDER FIRE AFTER LICENSE RECORDS REVEAL KEY GAPS
Abdul El-Sayed answers a question during a press conference at the Michigan Democratic Party State Endorsement Convention in Detroit on April 19, 2026. El-Sayed has never held a medical license in Michigan or New York. (Jose Juarez/AP Photo)
«They are the experts that a patient wants to see when they seek care,» El-Sayed continued. «And the decision about what healthcare is necessary ought to be held between a patient — and or their parents if they’re under the age of 18 — and their doctor. That’s it.»
The remarks come as the Trump administration has made major strides in restricting minors’ access to «sex-rejecting» procedures, which include hormone therapy and surgeries.
Earlier this week, the Justice Department announced that Mount Sinai had joined other hospitals, like Texas Children’s Hospital, the Cleveland Clinic Foundation and Connecticut Children’s Hospital, to halt sex change procedures for children after reaching an agreement with the Trump administration.
MEDICAID ENDS FUNDING FOR CHILD SEX-CHANGE PROCEDURES AS TRUMP ADMIN SLAMS ‘EXPERIMENTAL’ TREATMENTS
El-Sayed has made the promise of «Medicare-for-all» — government-run healthcare — as the major selling point of his campaign; he said that even though the government will be covering the bill, it needs to stay out of the doctor’s decisions about a patient’s treatment plan.
«I don’t think the government gets to have a say about what healthcare is provided in what circumstances and why,» El-Sayed said. «And to me, that is the standard on which we decide how we make healthcare decisions.»
THE MEDICARE FOR ALL TRADE-OFFS SOCIALISTS AREN’T TALKING ABOUT, ACCORDING TO EXPERTS
A protester holds a sign in support of sex changes for transgender children outside the U.S. Supreme Court in Washington, D.C., on June 18, 2025. (Anna Moneymaker/Getty Images)
«Not what the government says you can or can’t do, but what a patient and/or their parent, if they’re under 18, and their provider to decide. That’s the most important thing,» El-Sayed continued. «And there’s a lot of disinformation about us, what we’re talking about, when we talk about reproductive rights and when we’re talking about healthcare for the trans folks. But, in the end, the place where the rubber meets the rope is in that clinical room between a patient and a provider, and that to me is the center we should engage on.»
El-Sayed argued that Republicans agree with his belief that treatment decisions should be between a patient and their doctor, pointing to the Right to Try Act, which allows terminally ill patients to try experimental drug treatments that aren’t yet approved by the Food and Drug Administration after they have exhausted all other treatment options.
«Because conservatives fought for a very long time for this legislation called ‘Right to Try’ legislation, which is the idea that the government couldn’t tell you [that] you couldn’t have a certain medication,» El-Sayed said.
TRUMP ADMINISTRATION PROBE COULD UPEND WIDELY USED TRANSGENDER YOUTH TREATMENT GUIDELINES
A transgender rights supporter takes part in a rally outside the U.S. Supreme Court as the justices hear arguments in a case on transgender health rights in Washington, D.C., on Dec. 4, 2024. (Kevin Dietsch/Getty Images)
«So they agree that the decision about healthcare ought to be between the person and their provider. That’s it. So let’s use that standard, and keep to that standard, and make sure the government doesn’t have the ability to tell you what you can or cannot do with your own life,» El-Sayed said.
However, the research on the efficacy of treating individuals with gender dysphoria by allowing them to change sexes with «cross-sex» hormones and puberty blockers is limited.
The World Professional Association for Transgender Health, whose guidelines are used by leading medical associations like the American Academy of Peditatrics, is currently facing a lawsuit from the Federal Trade Commission stemming from allegations that its guidelines misled parents about the «medical consensus and medical necessity, as well as the safety and effectiveness» of sex change procedures.
The FTC has accused WPATH of failing to disclose the side effects associated with some procedures, such as patients experiencing incontinence, erectile pain, mood disturbances, pelvic pain and vaginal pain stemming from «cross-sex» hormones.
Meanwhile, countries that have socialized medicine have put restrictions in place for minors seeking sex changes. In England, the National Health Service put a pause on «cross-sex» hormones for 16- and 17-year-olds in March after finding research was «really weak» to support it.
The country already had a ban in place restricting children under 16 years old from taking sex-change hormones.
El-Sayed’s office did not immediately respond to Fox News Digital’s request for comment regarding his medical credentials.
politics, health, health care, abdul el sayed, health care executive
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