Colorado Isn’t Alone: Why States Across America Are Suddenly Cracking Down on Autism Services

Colorado’s recent audit of Medicaid-funded Applied Behavior Analysis therapy made national headlines, but the state is far from alone.

Federal auditors have identified tens of millions of dollars in improper Medicaid payments tied to autism-related services in multiple states, including Indiana and Maine. The findings have prompted increased oversight, provider reviews and discussions about whether the nation’s rapidly expanding autism-services system can continue operating under its current model.

At the center of the debate is a difficult question: Are these audits uncovering widespread fraud, or are they exposing the challenges of overseeing an industry that has grown faster than regulators anticipated?

The answer may be both.

Over the past decade, autism prevalence has continued to rise. The Centers for Disease Control and Prevention now estimates that 1 in 31 children in the United States has been identified with autism spectrum disorder, a dramatic increase from previous generations. As diagnoses increased, demand for services expanded alongside them.

ABA therapy emerged as one of the most widely funded autism inte…