State Medicaid Fraud Crackdowns Collide with Federal Autism Funding Expansion

Federal Research Funding Expands

The U.S. Congress has renewed the Autism Collaboration, Accountability, Research, Education and Support (CARES) Act through 2031, allocating $1.8 billion over five years primarily for autism research through NIH and CDC programs. This legislation, the primary federal autism research law, funds initiatives like the Autism Developmental Disabilities Monitoring Network but does not directly pay for therapeutic services. The renewal comes alongside autism-related provisions in the FY2026 federal budget.

Secretary Robert F. Kennedy Jr. has appointed a new Interagency Autism Coordinating Committee to guide federal research priorities, though some advocates question its focus given Kennedy's controversial views on autism causation.

States Target Medicaid Therapy Fraud

Separately, state Medicaid programs are addressing fraud in autism services. North Carolina implemented strict new rules in May 2026 banning out-of-state providers and limiting telehealth for applied behavior analysis (ABA) therapy after projecting $505 million in Medicaid spending. Families should verify their provider's status through the NC Medicaid portal.

A Minnesota audit revealed the Department of Human Services failed to adequately investigate potential kickback schemes prior to 2025 reforms. At least three states (NC, MN, and GA) are now pursuing legislation to increase oversight of Medicaid-funded autism services.

Navigating Complex Policy Changes

The situation creates challenges for families:

• Federal research dollars (CARES Act) flow separately from state Medicaid services
• ABA therapy remains controversial, with many autistic self-advocates criticizing its focus on compliance
• Rural families relying on telehealth face new restrictions in some states

The Autism Society recommends families: 1. Check provider Medicaid enrollment status 2. Understand telehealth allowances for initial vs. ongoing sessions 3. Contact local Protection & Advocacy organizations for legal guidance