For so many families with children diagnosed with autism or other developmental disorders, access to treatment like behavioral therapy is critical. But federal investigators say those resources have been targets for fraud in recent years. NBC6’s Amy Viteri investigates how one scheme worked and how it affects families.
For so many families with children diagnosed with autism or other developmental disorders, access to treatment like behavioral therapy, known as ABA is critical.
But federal investigators tell NBC6 Investigates those resources have been targets for fraud in recent years.
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“There was a particular group of individuals that were trying to circumvent the process of how individuals became licensed therapists, specifically in South Florida,” according to Assistant Special Agent in Charge Fernando Porras with the Department of Health and Human Services Office of the Inspector General (HHS/OIG) in Miami.
Investigators with HHS/OIG shared video with NBC6 Investigates they say shows a woman cheating on a test to become a registered behavioral technician to provide those services.
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“It's evident that she's talking to somebody in the room,” Porras said of the video, in which a man can be heard telling Grisel Farinas, the woman taking the exam remotely, not to look at him. At one point the man can be seen next to her in the video.
“Paid an individual $2,000 to help her walk her through having to take the test and essentially having that person take the test for her,” Porras said.
What they didn’t know is that the testing center was recording the session and the video would become evidence against Farinas, who eventually pled guilty to one count of healthcare fraud in 2022.
Investigations
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Investigators say it started with a tip about people cheating on virtual exams.
After testing centers were forced to close during the pandemic, they noticed a spike in people suddenly passing the test when allowed to take it remotely.
Investigators say it was part of a money-making scheme.
“They pay them a substantial amount of money to help them take the test,” Porras explained, “Then may or may not line them up with these providers that are also in cahoots with these individuals.”
According to court filings, once hired by a provider, Farinas purportedly provided services to two boys who were Medicaid recipients. More than $128,000 were billed to Medicaid in just a few months, for hours of therapy investigators say she admitted not providing.
Investigators conducted surveillance at the home and say Farinas would spend an hour or two inside, but was actually billing for much more.
“Ten hours a day, five days a week, holidays, summer, no breaks,” Porras said.
And according to investigators, even the mother of the two boys was getting a kickback.
“She was receiving payment for enrolling her two children,” Porras said.
Medicaid numbers from 2023-2024 show that of the 1.5 billion dollars paid out for ABA services in Florida, more than half was in Miami-Dade County.
Investigators say there was so much cheating in Florida, the companies ended remote testing in March 2021.
For mothers like Krystal Janet, any fraud involving these services just makes it harder for families.
She says her 7 year-old son J.J. was diagnosed with autism and a speech delay when he was 15 months old. She describes ABA therapy as life-changing.
“We depend on it for everything,” Janet said, “From toileting, to feeding, to socialization.”
But getting her son the help that he needs has not been easy.
“We were able to pay for it through the grants that are offered, and we qualified for, and we fought for,” she explained. “It's really hard. And our kids, for the most part, they can't advocate for themselves.”
She says this fraud is cheating not just government programs, but future generations of the help they need and deserve.
“You're cheating families, you're cheating kids, vulnerable kids,” she said, “…and it's just not fair.”
Farinas was sentenced to one month in prison and ordered to pay restitution for all the money billed to Medicaid. She told NBC6 Investigates by phone that anyone can make a mistake, adding she was not the only one involved and she has been punished for it.
No one else has been charged in this case. In court records, prosecutors stated Farinas agreed to cooperate with the investigation but was found to be an unreliable witness.
