Early Autism Project: Administrative Hours Billed as Child-Specific ABA

In the Early Autism Project fraud case, EAP paid the United States $8,833,615 to settle allegations of administrative work billed as child-specific ABA and padded therapy hours. The government said therapists had to reserve some of a child’s billable hours for regional managers who were not actively working with that child. For someone inside an autism provider, that is a recognizable question: whose work did the child’s claim actually pay for?

The Justice Department announced the settlement on August 2, 2018. Early Autism Project provided intensive behavioral treatment to children with autism in South Carolina. The claims involved TRICARE, the federal health insurance program for active and retired military members and their families, and South Carolina Medicaid, which provides health benefits to qualifying low-income residents.

How Administrative Hours Became Child-Specific ABA Claims

EAP allegedly required therapists to reserve billable time each week or month for positions called Regional Lead and Regional Coordinator. The government’s account concerned South Carolina Medicaid’s PDD Waiver. It described a company arrangement for allocating children’s hours to regional positions, with the resulting claims paying for administration and management.

The regional titles mattered because of what the people holding them were doing. According to the Justice Department:

The Medicaid payment rule described in that announcement required the person whose therapy was billed to be actively working with the child. Under the alleged arrangement, taxpayers paid for company management out of hours assigned to children with autism. A regional manager’s work could become a claim for a child’s treatment simply because the company reserved time for the position.

The government also alleged that EAP let therapists regularly pad the hours billed to both TRICARE and South Carolina Medicaid. Those programs allegedly paid for therapy that was never provided. The regional allocation and padded hours describe different ways the bill could exceed the treatment: assigning administrative work to a child, or adding time beyond the services delivered.

Billing Fraud, Unreasonable Expectations, or Both?

EAP faced billing-fraud allegations because, the government said, it charged children’s therapy hours for company management. The alleged problem was what reached the bill, not just what management expected of staff. The person who knows how regional hours were reserved may understand a billing practice that is hard to see from an individual treatment note.

ABA billing separates assessment, technician treatment, treatment that modifies a protocol, group work and family guidance. The service, the worker’s qualifications and the time represented all matter. A child’s authorization, the staffing schedule, the session note and the paid claim describe different parts of the same encounter.

That is why the work behind the title matters. An analyst modifying a child’s treatment protocol and a regional lead managing a business perform different functions. The EAP allegations concerned the latter being charged as child-specific therapy. We examine how the assigned work became a claim.

When the Treatment Note Contradicts the Bill

The HHS Office of Inspector General’s Indiana audit found claims for treatment-protocol modification even where session notes expressly said no modification had occurred, illustrating how a note can contradict the billed service.

For an EAP-style allegation, we connect the child’s authorization, the person doing the work, the contemporaneous note and the paid claim. The regional allocation adds another question: who decided that a management position would be funded through children’s therapy hours? Knowledge of that decision helps explain how the discrepancy reached the bill.

The Civil Case and the Whistleblower

A former EAP employee brought the False Claims Act lawsuit that led to the civil investigation. The Justice Department’s announcement said the whistleblower would receive a share of the recovery.

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers. For a worker who understands the allocation of therapy hours, the value is in explaining how an internal operating practice became a government claim. Our whistleblower experts work with that knowledge to develop the case.

An Executive’s False-Statement Plea

The Justice Department’s July 2019 criminal account reported that an EAP executive pleaded guilty to false statements to defraud Medicaid. That criminal account also described billing while traveling, waiting in driveways or sitting in restaurants. A restaurant table became a place to bill for a child’s therapy.

A Second Executive’s False-Statement Plea

The same criminal account reported a separate guilty plea by another EAP executive for false statements to defraud Medicaid.

What the Integrity Agreement Required

EAP and its parent, ChanceLight, entered a Corporate Integrity Agreement with the Department of Health and Human Services’ Office of Inspector General as part of the settlement. The agreement required internal compliance reforms, including hiring an independent review organization to conduct annual claims reviews.

The Same Billing Questions in Other Autism Cases

In its Applied Behavior Center for Autism settlement announcement, the Justice Department alleged that technician work was billed at analyst level and noncovered group ABA was billed as covered individual care.

The criminal charging account involving Smart Therapy alleged that maximum authorized hours were billed despite partial or absent treatment; the defendant in that scheme pleaded guilty to wire fraud in December 2025.

Across these cases, the person who knows the work can see what the bill conceals. Who treated the child, what they did, how long it took and how the company billed it can reveal the gap. That is the account we develop with a health care whistleblower who understands the operation.

You Know Whose Work Was Billed

If you saw management time assigned to children or therapy hours added beyond the work performed, tell our whistleblower experts how the billing operated. We build the case with you, bring in healthcare whistleblower lawyers who understand ABA billing, and stay beside you as the case moves forward.