Today's two deep dives cover New York's social adult day care fraud crackdown, where CMS wants a corrective plan in 30 days, and Maryland's stalled DDA appeals, now under federal review. Below are the day's other stories, each linked to its source.
Today's deep dives
New York social adult day care: CMS demands a fix in 30 days. What the raids, the first charges, the CMS letter and the governor's review mean for day programs, health plans and the staff who keep attendance records.
Maryland DDA appeals: CMS reviews 90-day deadline misses. What the federal fair-hearing rule requires, where the complaints stand, and what a stalled appeal means for agencies and self-directed families.
More news today
ABA Centers of America confirms a federal billing investigation. The Fort Lauderdale-based autism therapy chain says it is working with federal investigators, whose affidavit filed in New Hampshire describes a probe into alleged billing for medically unnecessary services and misstated service locations. No one has been charged, and the company says the inquiry is not about the quality of its care. Source: Disability Scoop (South Florida Sun Sentinel)
Virginia provider pays $1.82 million to settle Medicaid billing claims. Danville-based Negril Inc. agreed to pay $1,817,910.60 to resolve allegations that, from January 2021 to May 2022, it billed Virginia Medicaid under its own provider number for mental health skill-building services delivered by a company that wasn't enrolled in Medicaid. The settlement includes no admission of liability. Source: U.S. Attorney's Office, Western District of Virginia
Illinois drops its bid to close Choate's psychiatric unit, but cuts are still planned. The Illinois Department of Human Services withdrew its application to close all 75 inpatient psychiatric beds at Choate Mental Health and Developmental Center in Anna, but it still plans to cut to 25 beds. The local state's attorney says up to 15 more beds for people with developmental disabilities could still be removed, while the state says Choate's 40 forensic beds for people with I/DD will stay open. Source: WFIW
Louisiana moves EarlySteps intake to state regional offices. The Louisiana Department of Health's Office of Intellectual and Developmental Disability Supports is moving entry into EarlySteps, the state's early intervention program for children from birth through age 2, from contracted vendors to its own regional offices. The six-month switch ends March 31, 2027, and the department says families' services will continue without interruption. Source: Louisiana Department of Health
Ohio family sues Tallmadge group home over son's death. The family of Brian Taylor, 38, alleges that care at his group home declined after Empowering People took it over in 2023, and that a pressure wound led to his death from sepsis in May 2025. The provider had not responded to the station's request for comment. Source: Cleveland 19 News
KFF lays out the Medicaid changes coming after the midterms. KFF's Oct. 21 overview notes that 44 states, counting D.C., must start Medicaid work requirements by Jan. 1, 2027, and cites CBO's estimate that the 2025 law cuts federal Medicaid spending by $911 billion through 2034. It warns that tighter state budgets could mean lower provider rates or fewer benefits. Source: KFF