Medicaid fraud fears grow amid massive red state billing spike in sector that also plagued Minnesota
While fraud concerns are increasing across the country, especially in Medicaid, North Carolina State Auditor Dave Boliek told Fox News Digital that the problem is very real in his state, especially when it comes to autism therapy, a highly scrutinized field in Minnesota.
Boliek has been sounding the alarm about potential waste, fraud and abuse in the state’s Medicaid program, specifically citing an interview with Fox News Digital about a 47,000% explosion in autism treatment bills he has flagged since taking office last year.
“These are vital services to people and individuals who need therapy,” Boliek said. “But when you have a system, as in North Carolina, that goes from a total of $1.4 million for autism therapy to more than $660 million annually in bills for autism therapy over a five-year span, that requires an audit from the state auditor, who is the best watchdog agency in North Carolina to prevent taxpayer waste, fraud and abuse. So we dug into that, or right in the middle of it.”“
Boliek told Fox News Digital at the annual conference of the Government Financial Officers Foundation. Orlando’sHe says his office “goes hand in hand” with Vice President J.D. Vance’s focus on eliminating waste, fraud and abuse to ensure that people who need and deserve services receive them “without wasting money.”
North Carolina state auditor Dave Boliek presents a report at the Council of State meeting on February 4, 2025 in Raleigh, NC.
(Getty Images)
One of the main problems, Boliek explains, is that the system is often designed in a way that does not properly protect against waste and abuse.
“What we’ve had is we’ve seen examples where three different clinical providers billed an autism therapy client for the same time period, and that was because of poor rulemaking,” Boliek explained. “Some of it is probably illegal and probably illegal and we’re going to draw attention to that and try to handcuff people for it.”
“But some of this may be technically legal due to lax oversight by the Democrat-led Department of Health and Human Services,” Boliek said, referring to North Carolina’s top health agency.
The North Carolina Department of Health and Human Services presented data at a March 10, 2026 hearing of the Joint Legislative Oversight Committee on Medicaid that matched Boliek’s narrative of rapid growth in the field of autism therapy.
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Vice President Vance and CMS Administrator Dr. Oz is fighting fraud in areas such as Medicaid, nursing homes and suppliers of durable medical equipment.
The report confirmed that Medicaid spending on ABA (Applied Behavior Analysis) therapy increased 347% between 2022 and 2025 alone, with total spending expected to reach $842 million in state fiscal year 2026 and $1.14 billion in state fiscal year 2027.
Medical aid fraud has become a hot topic in the United States last fall, as a scandal in Minnesota gained widespread attention and spread to places like California and Ohio. Daily Wire expose It examines seven medical buildings in Columbus, Ohio, that house 288 Medicaid companies and bill the government $250 million.
According to Boliek, the fundamental problems with Medicaid and the ease with which it can be abused, both illegally and legally, are “the intricacies of rulemaking” that are “built in by the government.”
“For example, whether individual entities are providers of clinical medical services or whether they are providers of day care services or other services that may be paid through Health and Human Services departments, how those rules are established, and what their billing rules are,” Boliek explained.
“This is a really minor detail, but in North Carolina, for example, we still have some services that are offered on a fee-for-service basis, and they lack transparency and accountability around who can bill and how much can be billed for certain services. So we’ve taken a deep dive into some of the specific fee-for-service areas in North Carolina and we’re looking at provider data on exactly how those services are billed. That’s where the flaws are.”“
During a fraud scandal unfolding in Minnesota, federal agents discovered that a suspected fraudster defrauded the state’s nearly $14 million autism treatment program and allegedly billed Medicaid for fake therapy sessions, used untrained staff and paid parents $300 to $1,500 a month to keep their children in the program.
The budget for the state’s autism program has grown from $3 million in 2018 to nearly $400 million in 2023. Dr. Mehmet OzAdministrator of the federal Centers for Medicare and Medicaid Services.
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Minnesota Governor Tim Walz on January 5, 2026 in St. He announced at a news conference at the State Capitol in St. Paul that he would not seek reelection. Walz said he had concluded he could not fully dedicate himself to a political campaign and did not take questions from reporters. His announcement comes amid a major social services fraud scandal in the state.
“The fraud is so obvious that just looking at the exponential growth in some of these social service programs, anyone who looked at how fast it was growing should have known that fraud was the root cause of it,” Republican Minnesota state Sen. Michael Kreun told Fox News Digital in December about social services fraud in his state.
In terms of next steps in North Carolina, Boliek said his office is working with lawmakers to strengthen fraud enforcement by increasing financial accountability, expanding investigative and Medicaid oversight resources, and investing in personnel and technology to recover misappropriated funds.
Boliek explained that an important tool in the fight against fraud is: artificial intelligence.
““Look, we need to pour jet fuel into AI in the area of government oversight because fraudsters are using AI, and if we’re not using AI to fight fraud, then we’re going to be hounded and taxpayers aren’t going to be protected.”
He emphasized that these steps, especially to increase oversight of programs such as Medicaid, are aimed at holding individuals accountable and returning taxpayer money for more effective use.
The Government Financial Officers Trust is a group of fiscal officials who collectively oversee more than $3 trillion in government funds. published a report Earlier this year, it outlined how the organization was protecting more than $28 billion in waste, fraud and abuse in 2025 alone.
“Every dollar wasted is a dollar that could not be spent on a person who truly needs the service,” Boliek said. he said.
Original article source: Fears of Medicaid fraud grow as a surge in big red state bills for the industry also plagues Minnesota
