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Autism Therapy · Behavioral Health · Healthcare Regulation · Medicaid Fraud
Indiana-based Piece by Piece Autism Centers, an ABA provider, will shut down in May after the Indiana Family and Social Services Administration barred it from Medicaid due to questionable billing practices, including receiving $340,000 in 2023 and billing $58 million between 2019 and 2023.
The closure follows a Wall Street Journal investigation revealing Piece by Piece charged up to $640 per hour for services, making it one of the nation's costliest autism providers. Operations transfer to Applied Behavior Center for Autism, which itself settled for $2 million in 2023 over its own billing practices, as reported by the U.S. Attorney's Office.
Indiana's Secretary of the FSSA, Mitch Roob, mandated providers self-report fraud by April 3, 2026, a deadline the closure precedes. The state's behavioral health sector faces significant challenges with Medicaid reimbursement for autism services, including planned rate cuts in 2023.
A 2025 FSSA working group recommended aligning ABA utilization with clinical evidence, establishing sustainable reimbursement rates, and strengthening program oversight through a dedicated ABA office. This event reflects a broader federal crackdown on healthcare fraud, waste, and abuse as utilization and costs for behavioral health services climb nationwide.