House Probes Medicaid and Autism Therapy Billing Fraud Across 11 States

Two Committees, One Problem

Federal scrutiny of Medicaid fraud has expanded significantly in 2026, with parallel investigations running out of two separate House committees: the Committee on Energy and Commerce and the Committee on Education and the Workforce.

The targets range from a single Brooklyn-based autism therapy company to the Medicaid programs of 10 states.

The Brooklyn Autism Billing Probe

The House Committee on Education and the Workforce, led by Chairman Tim Walberg, R-Mich., and Rep. Rick Allen, R-Ga., sent a records request to The Perfect Child LLC, a Brooklyn-based autism therapy provider operating nationally. The committee is examining allegations of excessive billing, inflated service hours, and aggressive tactics against families when insurers refused to pay, according to the Daily Signal.

The lawmakers cited a Wall Street Journal investigation that documented one New Jersey mother who received a bill exceeding $900,000 for her child's therapy after being told upfront there would be no out-of-pocket costs.

The committee's letter specifically requested records from Simcha Bendet, the company's founder. It focused on how such practices affect employer-sponsored health plans, which cover 154 million Americans and carry fiduciary obligations under federal law. The letter warned that excessive charges and inflated out-of-network reimbursement demands could be passed directly to workers through higher premiums and reduced compensation.

10-State Medicaid Sweep

Separately, Rep. Brett Guthrie, R-Ky., chairman of the House Energy and Commerce Committee, along with subcommittee chairs John Joyce, R-Pa., and Morgan Griffith, R-Va., sent letters on March 3 to the governors and health agency heads of ten states: California, Colorado, Massachusetts, Maine, Nebraska, New York, Oregon, Pennsylvania, Vermont, and Washington.

The letters demanded records on investigatory processes, prior improper payments, recovery efforts, and audits, with written responses due by March 17, according to the House Energy and Commerce Committee's own press release.

The examples cited were concrete. In New York, two individuals tied to Brooklyn adult day cares pleaded guilty in January to stealing $68 million in Medicaid funds. A separate Queens-based scheme allegedly diverted $120 million from Medicaid and Medicare through kickbacks among adult daycare operators and a pharmacy. New York spent $115.6 billion on Medicaid for roughly 7 million people in fiscal year 2025, a figure Governor Kathy Hochul's own budget plan described as growing at "unsustainable levels," according to the House committee.

Nebraska's 1,800% Problem

Nebraska stands out as the only state with Republican leadership named in the probe. Nebraska Public Media reported that between 2020 and 2024, the state's Medicaid spending on Applied Behavioral Analysis, or ABA, therapy for children with autism increased by nearly 1,800%, reaching approximately $85 million in 2024 for more than 1,500 families.

A September 2024 Nebraska state audit flagged duplicate invoices, missing documentation, and providers lacking proper credentials in the ABA program. Nebraska has since lowered ABA reimbursement rates to bring them in line with surrounding states, a move expected to reduce spending.

Nebraska Governor Jim Pillen ordered an internal DHHS review after the probe was announced. DHHS CEO Steve Corsi's office confirmed receipt of the letter and said the department "maintains multiple layers of fiscal and programmatic safeguards," according to Nebraska Public Media.

Minnesota Admits Fraud, Defends Response

The investigations follow the well-documented fraud crisis in Minnesota, which resulted in the federal government withholding Medicaid funding from the state and drew scrutiny of Governor Tim Walz.

Minnesota DHS Temporary Commissioner John Connolly testified before the House Energy and Commerce Subcommittee on Oversight and Investigations, acknowledging plainly that "significant fraud happened" in the state's autism services program. Connolly told the committee that since 2020, Minnesota DHS has conducted more than 3,000 investigations, identified more than $50 million for recovery, and referred more than 500 cases to law enforcement, according to FOX 9's reporting on the hearing.

Connolly also pushed back on any disruption to Medicaid funding, arguing cuts would harm legitimate beneficiaries who depend on the program.

Access Barriers and Legitimate Concerns

Autism therapy is genuinely underserved, families of children with autism face enormous access barriers, and aggressive congressional scrutiny could spook providers or trigger overly broad audits that choke off care for kids who need it. A Nebraska legislative committee heard testimony in 2025 about the struggles families face accessing ABA services, and some advocates worry that fraud crackdowns may produce collateral damage for legitimate providers operating in a difficult reimbursement environment.

This concern is separate from whether fraud is occurring. The Nebraska audit findings, the $68 million and $120 million New York guilty pleas, and a $900,000 bill sent to a New Jersey family suggest the oversight failures are real and not hypothetical.

What Remains Unresolved

Chairman Guthrie said "Fraud shouldn't be a partisan issue." Nebraska's inclusion as a Republican-led state backs that up.

The question is whether the congressional document requests, which came with tight deadlines, translate into anything enforceable. The committees can investigate and expose. Prosecutions belong to the DOJ. How many of the 10 state responses actually produced substantive disclosures, and what referrals to the Justice Department have followed, has not yet been publicly reported.