States Adjust Oversight of Autism Services While Federal Funding Continues

States Address Billing Concerns in Autism Services

Several states are enhancing oversight of autism support services, especially those under Medicaid, due to concerns over billing practices. North Carolina has introduced new regulations that restrict out-of-state providers and limit telehealth for applied behavior analysis (ABA), a therapy some autistic individuals use. These adjustments follow a 2025 state audit revealing $505 million in questionable Medicaid expenditures on autism services.

Minnesota has also encountered challenges. A March 2026 audit identified shortcomings in the state's efforts to investigate potential kickbacks between autism service providers and schools before recent legal reforms. The audit underscores the necessity for improved fraud detection mechanisms.

These adjustments follow a 2025 state audit revealing $505 million in questionable Medicaid expenditures on autism services.

Federal Funding for Autism Programs Remains Steady

Amid state-level changes, federal funding for autism initiatives stays robust. Congress has approved Fiscal Year 2026 appropriations, maintaining support for autism research, early identification efforts, and training for service providers. This funding reflects ongoing bipartisan support for key legislation such as the Autism CARES Act, which allocates resources for autism-related programs.

The Biden administration has also reinforced its commitment to autism policy. In January 2026, HHS Secretary Xavier Kennedy appointed 21 new members to the Interagency Autism Coordinating Committee (IACC), a body that advises on federal autism research and service initiatives. However, Kennedy's focus on studying autism's origins has sparked debate among some Republicans, who question the allocation of research priorities.

Navigating Accountability and Access

The new state regulations aim to safeguard public funds, but advocates express concerns about potential impacts on service access. North Carolina's restrictions on telehealth and out-of-state providers could particularly affect rural families, as reported by Behavioral Health Business. Policymakers face the challenge of implementing oversight without creating barriers for autistic individuals who depend on these services.

ABA, while widely used, is a topic of debate within the autistic community. Some individuals report positive experiences, while others, including many self-advocates, raise concerns about its methods and goals. It's important to recognize the diversity of needs and preferences among autistic individuals when discussing support options.