A federal Medicaid audit in Colorado revealed massive overpayments for an autism therapy called applied behavior analysis (ABA).[1] The state Medicaid program paid for the services of unqualified behavioral technicians for children with autism, resulting in a potential refund of $60 million to $150 million to the federal government.[1] Overpayments arose due to incorrect documentation of services and invoicing of services not received.[1] Last fiscal year, spending on this therapy reached $287 million, a 45% increase from $207 million the previous year.[1] The state faces a $1 billion budget deficit, which threatens other programs for low-income people and people with disabilities.[1] Medicaid officials have acknowledged that paying unqualified technicians creates health and financial risks.[1] Therapy providers complain about low reimbursement rates and long waiting lists after several firms exit in 2022 and 2023.[1] In September 2024, providers sued Colorado over the pre-approval requirement for Medicaid services.[1]