Lovaas Midwest is Fined almost 3 Million Dollars by the Centers for Medicare and Medicaid Services

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Alright – so, unless you live under a rock, don’t have a child with autism, don’t work in the field of autism, etc. then you heard of Lovaas autism clinic. Let’s give a brief history. Dr. Ivar Lovaas, a researcher from UCLA did an autism study on 19 kids in 1987. He found that 47% entered mainstream kinder garden without any special education assistance. This study was repeated four years later and most of those 47% kept their gains. Lovaas used discrete trial teaching (DTT) which has been widely researched and is found to be one of the most effective methods of applied behavior analysis (ABA). As a result of this significant study, Lovaas is often called “the father of ABA”.

There is Lovaas West Coast where Dr. Lovaas started, now led by Scott Wright, Lovaas East Coast led by his wife Linda Wright and Lovaas Midwest in Minneapolis led by their friend Dr. Larsson. Then there is Lovaas Center. in Nevada led by Dr. Lovaas’ son Eric Lovaas which has no connection to Lovaas East, West or Midwest. It can sound confusing, but really it is not.

Dr. Larsson who heads Lovaas Midwest in Minneapolis used to work at Minnesota Autism Center (MAC) back when they were Families for Effective Autism Treatment (FEAT). Under his care is when MAC overbilled Medicaid for autism services over three million dollars and was fined to pay back $600,000. From what I understand Ron Carey fired Larsson in some hallway. Larsson then stole most of MAC’s employees and MAC sued him winning that lawsuit.

To make a long soap opera autism story in Minnesota short, Dr. Larsson continued his ways of overbilling and simultaneous billing when he started Lovaas Midwest. He kept doing this for years despite the state Medicaid agency telling him to not do it. Finally, the state Medicaid agency (under Gov Pawlenty) made a bad deal with Larsson and told him via courts in the case of Huisenga vs. MN State Medicaid agency that they won’t ask back any overpaid funds but he could no longer bill for simultaneous services.

Then CMS audited Lovaas Midwest and found overbilling stating while the state might have a deal with Larsson, the federal government which pays half of the funds will not. Thus, Lovaas was fined by CMS to pay back $2,862,769. Personally, I am not a big fan of Lovaas Midwest nor Dr. Larsson as I think they have bias policies in their clinic, and I am glad someone finally stood up to him and Lovaas.

Below is what CMS said in their outcome.

The provider was wrongly paid for having multiple mental health professionals at the same time for the same child which is not allowed by Medicaid guidelines. Provider was paid for travel time for unrelated services, Provider was paid for services without any child/parent present or non-direct services meaning the child and/or parents were not present as it is stated in Minnesota Statute 256B.0943 Subd. 11, the list is long but you get the point.

Lovaas Midwest is directed to;

Submit payment to the State of Minnesota for $2,862,769, the amount owed to Medicaid. The commissioner will seek recovery from a vendor. The commissioner is authorized to calculate the amount of monetary recovery based on estimation from systematic random samples of claims submitted and paid. The commissioner will recover money by the following means:  Permitting voluntary repayment of money, either in lump sum payment or installment payments; • Deducting or withholding from MHCP payments; • Withholding payments to a provider under the Code of Federal Regulations, title 42, section 447.31.

Where is the outrage or relief from DHS and the welcoming media that reports relentlessly when Somali child care centers sneeze the wrong way or any provider of color does anything wrong? Racial disparity is not just access to health care, it is also how different providers are treated. Anglo providers are given second and third chances, they are able to negotiate or appeal decisions. For minority owned providers – don’t even think about it is the answer.

Above words do not represent any committee, candidate or agency.

Idil – Somali Autism Mom & Minority Advocate

 

Category: Autism Policy