10/22/2026
Proud to be locally, BCBA-owned! 🩷🦋
Minutes after an autistic 3-year-old lay her head on a Squishmallow stuffed toy and closed her eyes, Abigayle Hosking was ordered to take the makeshift pillow away and rouse the sleepy girl.
The child was scheduled for four more hours of autism therapy at the Centria Healthcare clinic in Michigan where Hosking worked until last year.
Hosking said she felt terrible. “The younger kids, you know, I think they need a break,” she said.
Medicaid plans and private insurers will often pay for up to about 40 hours of autism therapy a week, and shut-eye doesn’t count. At Centria and some other large chains backed by private-equity investors, former employees said in interviews that they felt pressure to maximize therapy hours, claims the companies dispute.
“It’s simple business math,” said Philip Painter, a physician who briefly served as chief medical officer at Centria. “You want to maximize the number of hours the child is doing.”
Medicaid programs financed by state and federal taxpayers paid $10 billion for autism therapy last year, up from around $2 billion in 2021, driven in part by increasing numbers of treatment hours per patient.
In autism therapy, treatment hours are supposed to be tailored to each patient’s needs, but there is debate about how much is warranted.
See the data showing how some private-equity-backed autism companies billed far more therapy hours than rivals:
🔗 https://on.wsj.com/4ivWAU6
