Medicaid spending on Applied Behaviour Analysis therapy for children with autism has risen to about $5 billion, prompting concern about possible fraud and weak oversight. The article says the therapy can be vital for helping children develop communication, social and everyday living skills, but argues that rapid growth in publicly funded provision has created opportunities for abuse.

It reports that the Trump administration is increasing scrutiny of Medicaid programmes as states debate how to control costs and police providers. The issue has also become politically divisive, with disagreement over whether stronger safeguards could restrict access for families who rely on the therapy.