Letitia James, Medicaid Defunding Block, New York 2023

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Rhode Island’s Medicaid Scam Exposed

A shocking investigation by the United States government has uncovered a brazen Medicaid scam in Rhode Island, where children with disabilities were denied community-based services, forcing them into residential treatment facilities.

The alleged Medicaid scam was first exposed by a complaint filed by the parents of a child with autism, who claimed that their minor son was only receiving half of the authorized community-based Medicaid services. The parents alleged that Rhode Island Executive Office of Health and Human Services (EOHHS) had authorized 25 to 34 hours per week of community-based services, but their son was only receiving an average of 17 hours per week.

The United States government opened an investigation into the complaint, and the child was eventually forced to enter an out-of-state residential treatment facility for several months. Assistant Attorney General Kristen Clarke of the Civil Rights Division stated, “The ADA requires states to provide disability services in the most integrated setting appropriate so that children with disabilities can remain at home with their families.”

U.S. Attorney Zachary A. Cunha of the District of Rhode Island added, “Integrated, community-based services for children with intellectual and developmental disabilities are critical to keeping families together and ensuring that children receive care in a supporting and loving environment; no family should be forced to make a choice between care and separation from their children when adequate support is possible in a community setting.”

Under the terms of a settlement agreement, Rhode Island will modify its policies to ensure that children with intellectual and developmental disabilities, such as autism, receive the community-based services to which they are authorized. The state will also create an ombudsman program to allow individuals and their family members to express concerns.

The state will pay $75,000 in damages to the complainants’ son and develop an individualized service plan to identify the community-based services necessary for him to live at home. The investigation was handled jointly by Assistant U.S. Attorney Amy Romero for the District of Rhode Island and the Civil Rights Division’s Disability Rights Section.

The settlement agreement marks a significant victory for the disability rights community and serves as a reminder of the importance of enforcing the Americans with Disabilities Act (ADA). The Justice Department plays a central role in advancing the ADA’s goals of equal opportunity, full participation, independent living, and economic self-sufficiency for people with disabilities.