12/16/2024 -- FBI Raids Autism Centers

Crime

FBI Raid Of Autism Centers Has Connections To Feeding Our Future Fraud Case

In Friday’s newsletter we told you about the autism fraud investigation. Here is the latest information from this story.

Summary: An FBI raid on two Minnesota autism centers has revealed a Medicaid fraud scheme involving millions of dollars in false claims for services under the Early Intensive Developmental and Behavioral Intervention (EIDBI) program.

Background on the EIDBI Program: The EIDBI program, funded by state and federal governments, provides services to individuals under 21 with autism spectrum disorder.

Fraudulent Claims and Evidence: Medicaid payments for EIDBI services in Minnesota surged from $1.7 million in 2017 to $400 million by 2023–2024. The FBI has identified significant irregularities, including claims for services not rendered.

Smart Therapy Center: Smart Therapy Center, which received $13.8 million in Medicaid reimbursements between 2020 and 2024, is accused of submitting fraudulent claims. The clinic allegedly hired unqualified staff, including relatives of the owners, and billed for services not provided or conducted by unregistered individuals.

Connections to Feeding Our Future: The investigation revealed links between individuals involved in the Feeding Our Future fraud and the autism centers under scrutiny. Smart Therapy Center also participated in Feeding Our Future’s federal food aid program, further connecting the schemes.

Impact and Future Actions: No charges have been filed yet, but the U.S. Attorney’s Office is reviewing evidence for potential indictments. Meanwhile, the Minnesota Legislature is considering licensing autism centers to enhance oversight and prevent similar fraud.

Business

❯ 2024 Person of the Year: Tim Connelly, hired as president of basketball operations for the Minnesota Timberwolves in 2022, has been named the Twin Cities Business Mag Person of the Year. Since joining the team, Connelly has significantly transformed the team and led them to the Western Conference finals for the first time in two decades.

❯ UHC Faces Lawsuit: A federal lawsuit filed by SpecialtyCare physicians accuses UnitedHealthcare of deliberately engaging in "deny, delay and underpay" practices, leading to over $900,000 in unpaid independent dispute resolution awards. The lawsuit alleges that UnitedHealthcare uses the Federal No Surprises Act to deny, delay, and underpay out-of-network providers.

❯ Player’s Health Raises $60M: Players Health, a Minneapolis-based sports tech company, has successfully closed a $60 million Series C funding round, bringing its total funding to over $100 million. The company plans to use the investment to enhance its AI-powered services, pursue strategic mergers and acquisitions, and expand its workforce.

What Else We’re Reading…

UnitedHealthcare Faces Backlash Over Denial of Autism Therapy Coverage

ProPublica has published a new story looking into UnitedHealthcare's denials of autism therapy. The investigation revealed the UHC’s subsidiary Optum has been denying necessary therapy hours for children with autism, as part of an internal cost-cutting strategy to manage the increasing expenses associated with autism care. The insurer is limiting access to applied behavior analysis therapy by reducing provider networks and denying coverage based on arbitrary criteria, despite ABA being the gold standard for autism treatment.

Read the full investigation on ProPublica

GAME: Mini Crossword

Do you know who the Vikings play tonight? That’s the answer to 1 Down in today’s mini crossword

Sports 🏈

🏈 In D2 and D3 football news, Bethel and Minnesota State Mankato were both eliminated from the playoffs. Bethel’s game came down to a controversial penalty that wiped away a game-winning touchdown.

🏒 The Gopher Men’s Hockey team had a tough weekend in their match-up against #2 Michigan State at home. They tied the first game and blew a two goal lead in the second game.

🏀 The Minnesota Timberwolves beat the Los Angeles Lakers and the San Antonio Spurs over the weekend. They have now won 6 out of their last 7 games.

🏒 The Minnesota Wild split their weekend games with a win over the Philadephia Flyers by a score of 4-1 including this improbable goal, and a loss to the Vegas Golden Knights.

Quick hits

Headlines From Around The Twin Cities ✔

❯ Three Minnesotan’s were among just 39 people to receive full pardons from President Biden (Bring Me The News)

❯ It was a tough weekend to drive across Minnesota as freezing rain led to hundreds of crashes (WCCO)

❯ Local celebrity chef Justin Sutherland has officially been sentenced for domestic abuse (Fox9)

The Wells Fargo building in downtown Minneapolis sold for a steep discount (F&C)

The Final Word: Hopeful for Snow? ❄

For the second straight winter we have hardly any snow on the ground in mid-December and the outlook for a white Christmas is bleak. I hate to be a grinch, but I actually enjoy the lack of snow…am I alone? Answer the poll below and let me know.

-Patrick