Costliest Autism-Therapy Firm—Which Was Barred From Medicaid—Is Closing

A rival provider, which recently settled civil allegations of fraudulent Medicaid billing, to take over operations at Piece by Piece Autism Centers

By Christopher Weaver of The WSJ. Excerpts:

"The nation’s costliest autism therapy provider will shut down by mid-May"

"the state of Indiana said it would bar the firm from billing Medicaid."

"The autism-therapy provider, Piece by Piece Autism Centers, received $340,000 in Medicaid payments per patient in 2023, the highest level in the country"

"Once Piece by Piece—which state officials have said abused the taxpayer-funded program for low-income people—closes, its centers will be operated by a rival autism-therapy provider"

"Piece by Piece extracted its high payments in part by boosting list prices to levels that allowed it to collect as much as $640 an hour from the state"

"From 2019 to 2023, Indiana directly paid Piece by Piece $58 million"

"State Medicaid programs’ direct payments for the therapy grew to $2.2 billion in 2023, from $660 million just four years earlier"

"At first, owner Meghann Mitchell, who purchased a $2.5 million Sanibel Island vacation home, a $600,000 riverfront Indiana getaway and other properties as Piece by Piece’s billings soared, was defiant. She wrote to employees that “Piece by Piece has done nothing wrong and intended to fight this decision,”"

"Mitchell also owns, through a limited liability company, real estate used by the centers—meaning she could remain a landlord for her former business."

"Indiana is undertaking a wider overhaul of how it covers autism therapy. For years, Indiana had paid autism-therapy providers 40% of whatever list prices they charged, leading to ultrahigh payments for some providers. The state set a flat rate in 2024."

"Indiana also plans to seek federal approval for a moratorium on new autism-therapy providers this month"

Related posts:

The Boom in Autism Therapy Is Medicaid’s Fastest-Growing Jackpot: Some companies have found lucrative opportunities to capitalize on a growing need, billing long hours and extracting payments as high as $800 an hour (2026)

Autism-Therapy Firm That Was Paid $340,000 per Patient Is Barred From Medicaid: Indiana officials move to terminate Piece by Piece Autism Centers, cite federal pressure for crackdown after a Journal investigation (2026) 

The Medicaid Autism Racket: Behavioral therapy payments are an easy target for fraud (2026)