Star Tribune
Minnesota autism providers under investigation, lawmakers eye ‘guardrails’
Investigators are examining potential Medicaid fraud among Minnesota autism services, and state lawmakers say they will consider licensing the providers, whose numbers have increased dramatically across the state.
The Minnesota Department of Human Services has 15 active investigations into organizations or individuals providing certain autism services and has closed 10 other cases, the agency told the Star Tribune. The investigations were first reported by the the Reformer, which wrote last month that the FBI is looking into fraud by autism service providers.
Gov. Tim Walz said Wednesday that he’s “not aware” of an FBI investigation, but is concerned about the allegations of fraud.
Officials with DHS were not available for an interview Wednesday, but the department issued a statement saying: “Early identification and access to services are life-changing for people with autism — especially children. That’s why it’s so important to make sure every dollar spent on services is accounted for.”
The state created a medical benefit about a decade ago for young people with autism spectrum disorder and related conditions. The number of people receiving the early intensive developmental and behavioral intervention benefit and the providers getting paid for the services has climbed sharply in recent years, as have the dollars flowing to those providers.
The providers offer therapy and services. The benefit program is intended to educate and support families of people with autism, help individuals be more independent and participate in their schools and communities and improve their lives long-term.
There were 328 related providers in the state last year, up from 41 in 2018, according to DHS data. The amount the providers were paid has also spiked during that time, from $6 million to nearly $192 million.
The state has withheld payments to seven autism service provider organizations since 2018, according to DHS. Five of those were withheld for credible fraud allegations. DHS said another payment was denied because the provider failed to allow DHS access to records and one was withheld “to protect the public welfare and in the best interests of Minnesota Health Care Programs.”
“DHS took action to withhold payments when there were credible allegations of fraud and forwarded cases for law enforcement investigation or prosecution when appropriate,” the DHS statement said. “These investigations follow a national trend of identifying fraud in Medicaid-funded autism services.”
Future license requirements?
The hundreds of autism-related service providers do not need a state license to provide the benefit services. But last year lawmakers tasked DHS with reviewing the service and evaluating whether they needed to license the organizations or make other regulatory changes.
“There’s a need for service and the demand for service is high. But the question is do we need to put guardrails?” said House Human Services Finance Chairman Mohamud Noor, DFL-Minneapolis. He said they are looking into that question for both autism centers and telehealth services, to ensure “there is proper care for the most vulnerable children in our state.”
The state should be licensing autism centers and in-home providers, who offer the same services in different settings, said Rep. Kim Hicks, DFL-Rochester, who has previously worked as the autism policy lead at the Department of Human Services.
“It’s really important that our programs be something that works to support kids and families and doesn’t cause harm. And so to do that I think we need more oversight and regulation, particularly when we’re talking about licensing of centers,” she said.
Legislators agreed this year to license behavior analysts who provide certain therapies and it makes sense to next look at licensing autism-based centers, said Senate Human Services Chairman John Hoffman, DFL-Champlin.
“It’ll be part of our hearing structure,” Hoffman said, if he continues to serve as committee chair. “It’s worthy of a conversation. Let’s get the autism experts at the table and let’s talk about it.”
Hoffman said he is not surprised by the growth in the autism program, which he believes is fairly consistent with other new DHS programs. Prior to 2018, Hoffman said, autism support services were lacking in the state.
One in 34 children in Minnesota was identified as being on the autism spectrum, according to 2020 data from the Minnesota-Autism and Developmental Disabilities Monitoring Network. That’s higher than the national rate.
A spokeswoman for Walz said their office will “definitely take a look” at whatever licensing requirements lawmakers propose.
Concerns about fraud
The concerns about autism providers misusing federal dollars come as another state agency, the Minnesota Department of Education, has been in the spotlight for failing to safeguard against fraud in the Feeding Our Future case. Seventy people have been charged in what prosecutors have said was a massive scheme to steal from federal food programs.
DHS said it has systems to identify fraud, waste and abuse and acts swiftly when they are suspected. The agency’s Office of Inspector General can investigate suspected fraud and stop providers’ ability to bill for services, and forward fraud findings to the Attorney General’s Office for prosecution.
Asked about other Medicaid program cases, a DHS spokesman said the agency has 548 total open investigations.
Last month, the Attorney General’s Office charged five people in two investigations — one related to home care services, another to medical transportation — with defrauding Minnesota’s Medicaid programs out of more than $10 million.
The Attorney General’s Medicaid Fraud Control Unit has had 261 criminal convictions in cases since October 2018, and nearly $26.5 million in criminal restitution has been ordered as a result, according to data from the Attorney General’s Office.
In the case of children receiving autism services, DHS officials said their Disability Services Division evaluates a child’s progress with treatment plans to ensure services should continue to be authorized. The agency said it instructs the managed care organizations it works with to follow similar authorization protocols. Its Office of Inspector General also does complaint-based investigations and audits to check compliance with Medical Assistance requirements.
Staff writer Ryan Faircloth contributed to this report.
”Hey guys, they’re now scrambling and trying to call us Nazis and fascists,” said Alina Habba, one of Trump’s attorneys, who draped a sparkly ”MAGA” jacket over the lectern as she spoke. ”And you know what they’re claiming, guys? It’s very scary. They’re claiming we’re going to go after them and try and put them in jail. Well, ain’t that rich?”
Declared Hogan in his characteristic raspy growl: ”I don’t see no stinkin’ Nazis in here.”
Trump has denounced the four criminal indictments brought against him as politically motivated. He has ramped up his denunciations in recent weeks of ”enemies from within,” naming domestic political rivals, and suggested he would use the military to go after them. Harris, in turn, has called Trump a ”fascist.”
The arena was full hours before Trump was scheduled to speak. Outside the arena, the sidewalks were overflowing with Trump supporters in red ”Make America Great Again” hats. There was a heavy security presence. Streets were blocked off and access to Penn Station was restricted.
In the crowd was Philip D’Agostino, a longtime Trump backer from Queens, the borough where Trump grew up. The 64-year-old said it was appropriate for Trump to be speaking at a place bills itself as ”the world’s most famous arena.”
”It just goes to show ya that he has a bigger following of any man that has ever lived,” D’Agostino said.
Star Tribune
Biden calls out Musk over a published report that the Tesla CEO once worked in the US illegally
NEW YORK — President Joe Biden slammed Elon Musk for hypocrisy on immigration after a published report that the Tesla CEO once worked illegally in the United States. The South Africa-born Musk denies the allegation.
”That wealthiest man in the world turned out to be an illegal worker here. No, I’m serious. He was supposed to be in school when he came on a student visa. He wasn’t in school. He was violating the law. And he’s talking about all these illegals coming our way?” Biden said while campaigning on Saturday in Pittsburgh at a union hall.
The Washington Post reported that Musk worked illegally in the country while on a student visa. The newspaper, citing company documents, former business associates and court documents, said Musk arrived in Palo Alto, California in 1995 for a graduate program at Stanford University “but never enrolled in courses, working instead on his startup. ”
Musk wrote on X in reply to a video post of Biden’s comments: ”I was in fact allowed to work in the US.” Musk added, ”The Biden puppet is lying.”
Investors in Musk’s company, Zip2, were concerned about the possibility of their founder being deported, according to the report, and gave him a deadline for obtaining a work visa. The newspaper also cited a 2005 email from Musk to his Tesla co-founders acknowledging that he did not have authorization to be in the U.S. when he started Zip2.
According to the account, that email was submitted as evidence in a now-closed California defamation lawsuit and said that Musk had apllied to Stanford so he could stay in the country legally.
Musk is today the world’s richest man. He has committed more than $70 million to help Republican presidential nominee Donald Trump and other GOP candidates win on Nov. 5, and is one of the party’s biggest donors this campaign season. He has been headlining events in the White House race’s final stretch, often echoing Trump’s dark rhetoric against immigration.
Trump has pledged to give Musk a role in his administration if he wins next month.
The only debate between DFL U.S. Sen. Amy Klobuchar and GOP challenger Royce White started Sunday on the street outside WCCO Radio.
As White approached the building, he loudly called some two dozen flag-waving and cheering Klobuchar supporters a “whole lot of commies.” The 33-year-old provocateur and podcaster also told them to thank Republican former Vice President Dick Cheney — who endorsed Democratic Vice President Kamala Harris — because there was “no chance in hell” that Harris would defeat Republican former President Donald Trump on Nov. 5.
Klobuchar, 64, had arrived moments earlier, smiling and wishing “good morning” to her supporters. Once inside, the two took questions for an hour from moderator Blois Olson. Their tone was generally polite with White often interrupting a Klobuchar response with, “rebuttal,” indicated he wanted to respond.
The senator repeatedly raised White’s claims on X, formerly Twitter, that “The bad guys won in World War II” and that there were “no good guys in that war.” She called that stance offensive to veterans.
U.S. Sen. Amy Klobuchar arrives at WCCO Radio for a debate with Royce White in Minneapolis on Sunday, Oct. 27. (Richard Tsong-Taatarii)
Klobuchar, who is seeking a fourth six-year term, portrayed herself as a pragmatist. She opened by saying that we live in “incredibly divisive times politically” but that she has listened and worked with Republicans to bring down shipping costs, drug prices for seniors and to help veterans and push for more housing and child care.
“Courage in this next few years is not going to be standing by yourself yelling at people,” she said, her opening allusion to White’s rhetoric, which she said is often vulgar.
White, a former NBA player, is a political novice, but a close ally of Steve Bannon, the jailed former chief strategist for Trump and right wing media executive. Last summer, White won the state GOP endorsement to run against Klobuchar.
“Our country’s coming undone at the seams. I think we can change that,” White said in his opening statement. He said he threatens the status quo, decried the “permanent political class” and referred to the two major parties as the “uniparty.”
