Colorado’s ABA Reckoning: Why Medicaid Spending Exploded—and What Happens Next

For years, Colorado has been viewed as one of the most supportive states in the nation for families raising children with disabilities.

Parents seeking autism services, Medicaid supports and specialized therapies often looked to Colorado as a place where help was more readily available than in many other parts of the country. The state’s Medicaid program covered Applied Behavior Analysis, or ABA, therapy for eligible children with autism, and a growing network of providers helped meet increasing demand. As autism diagnoses rose nationwide, Colorado became a destination for some families seeking access to services that were difficult to obtain elsewhere.

Now that same system is facing one of the most significant oversight overhauls in its history.

A federal audit conducted by the U.S. Department of Health and Human Services Office of Inspector General found that Colorado made at least $77.8 million in improper fee-for-service Medicaid payments for ABA therapy provided to children with autism. Auditors also identified an additional $207 million in payments that may have been improper but could not be fully verified becaus…