The value of autism therapy billings to the state’s Medicaid program grew by approximately 47,000 percent over a five-year period, according to North Carolina’s elected state auditor, raising concerns about potential waste, fraud, or abuse.
In 2020, providers billed Health and Human Services approximately $1.4 million annually for autism therapy services, according to Dave Boliek, who assumed office last year and is in charge of all state agency finances.
That amount has subsequently skyrocketed to $660 million annually, according to Boliek. “Those are vital services to folks and individuals that need that therapy,” Boliek stated in an interview with Fox News Digital. We are the leading watchdog organization for preventing taxpayer waste, fraud, and abuse, so that calls for an audit by the state auditor. We have thus investigated that.
The North Carolina Department of Health and Human Services (NCDHHS) reported in March that around $544 million in Medicaid dollars were spent on “Research Based Behavioural Health Therapy” in fiscal year 2025, albeit it is unclear whose data set Boliek is referring to.
The report defines this type of therapy as a “suite of evidence-based interventions that prevents or minimises the behavioural challenges associated with Autism Spectrum Disorder.”
The state is predicted to spend $842 million on these services by fiscal year 2026 and $1.1 billion by fiscal year 2027. According to the analysis, the number of people using these therapies decreased from 13,447 in 2025 to just 3,844 in 2022.
According to the paper, “utilisation growth far outpaces increases in Autism Spectrum Disorder (ASD) diagnosis,” and it is “unlikely that this level of growth can be explained by increased access alone.”
Medicaid spending at the state level for therapies connected to autism has increased by 47,000 percent over the past five years, according to North Carolina State Auditor Dave Boliek.
Boliek stated that in order to determine why expenses have skyrocketed, he is collaborating with Vice President JD Vance, who has emerged as the Trump administration’s main person on fraud investigations.
The NCDHHS was contacted by The Daily Mail for comment.
Boliek stated that he and Vice President JD Vance are collaborating “hand in glove” to determine why these expenses are increasing so rapidly.Vance has come to represent the Trump administration’s efforts to combat fraud in Minnesota and other places where programs are thought to be flawed.
Numerous individuals in the state have been accused by federal prosecutors of embezzling over $250 million from a pandemic food assistance program, while other investigations have claimed fraud in the state’s autism treatment program.
In response, Vance declared in February that Minnesota’s Medicaid funds had been frozen by the Trump administration to the tune of around $260 million. Since then, the White House has established a task force to look into possible fraud schemes of a similar nature in California, Illinois, New York, Maine, and Colorado.
Boliek thinks that a general lack of knowledge about who should submit bills to Health and Human Services in North Carolina is the cause of the possible fraud he is involved in. “We’ve seen examples where there might be three different clinical providers billing during the same tranche of time on an autism therapy client and that is because of poor rulemaking,” he added, adding that some cases of duplicative billing are probably illegal. “We’re going to point out that some of it is probably illegal and possibly illegal, and we’re going to try to put people in cuffs because of that.”
Boliek went on to say that Dr. Devdutta “Dev” Sangvai’s “lax oversight” at the NCDHHS is partially to blame. Governor Josh Stein, a Democrat, appointed him to the position last January.
Boliek highlighted that unclear billing regulations can cause confusion for providers or enable individuals to exploit the intricate system.
Boliek thinks that the North Carolina Department of Health and Human Services’ “lax oversight” is partially to blame for costs spiralling out of control.Since last year, Dr. Devdutta “Dev” Sangvai (pictured) has been in charge of the organization.
Sangvai was appointed by Democratic Governor Josh Stein in January of last year, not long after he took office. “It truly is minutiae… He stated, “We’ve taken a deep dive into some specific fee-for-service areas in North Carolina and are looking at provider data on exactly how those services are billed because we still have some services that are delivered on a fee-for-service basis, and they lack transparency and accountability with regard to who can bill and how much can be billed for particular services.” The defects are located there.
Boliek stated that his office is collaborating with legislators to bolster enforcement mechanisms through the expansion of investigation resources and the imposition of harsher fines.
Artificial intelligence is one tool Boliek intends to use to detect fraud. “Look, we’ve got to pour jet fuel on artificial intelligence in the area of state auditing because the fraudsters are using AI and if we’re not using AI to combat the fraud, then we’re going to be on our heels and the taxpayer isn’t going to be protected,” he stated.
He stated that these actions are being taken to ensure that the appropriate individuals receive the resources they require.
According to Boliek, “every wasted dollar is a dollar that can’t be spent on a person who actually needs services.”
