As fraud concerns ramp up across the country, particularly involving Medicaid, State Auditor Dave Boliek tells Fox News Digital that the problem is very real in his state, especially when it comes to autism therapy, an area that has been highly scrutinized in Minnesota.
Boliek is sounding the alarm on potential waste, fraud, and abuse within the states Medicaid program, specifically calling out in an interview with Fox News Digital a 47,000% explosion in autism therapy billings that he has flagged since taking office last year.Â
“Those are vital services to folks and individuals that need that therapy,” Boliek said. “But when you have, like in North Carolina, a system that went from $1.4 million or so in total billings for autism therapy to more than $660 million a year in billings on autism therapy within a five-year range, that begs an audit from the state auditor, who in North Carolina, we are the top watchdog agency for taxpayer waste, fraud, and abuse prevention. So we’ve dug down into that or in the middle of that.“
Boliek, who was speaking to Fox News Digital from the State Financial Officers Foundation annual conference in , says his office is “hand-in-hand” with Vice President JD Vances focus on eliminating waste, fraud, and abuse to “make sure that the people who need the services and deserve those services get the services” without “wasting money.”
One of the core problems, Boliek explained, is that the system is oftentimes designed in a way that fails to properly safeguard against waste and abuse.
“What weve got is weve seen examples where there might be three different clinical providers billing during the same tranche of time on an autism therapy client and that is because of poor rulemaking,” Boliek explained. “Some of it is possibly illegal and probably illegal, and were going to point that out, and were going to try to put people in cuffs because of it.”
“But some of it might be technically legal because of the lax oversight from a Democrat-led Department of Health and Human Services,” Boliek said, referencing the top state health agency in North Carolina.
In a March 10, 2026, hearing of the Joint Legislative Oversight Committee on Medicaid, the North Carolina Department of Health and Human Services presented data that matches Boliek’s narrative of exponential growth in the autism therapy space.
The report confirmed that Medicaid spending on ABA (Applied Behavior Analysis) therapy grew by 347% between 2022 and 2025 alone and that total spending is projected to hit $842 million in state fiscal year 2026 and $1.14 billion by state fiscal year 2027.
Medicaid fraud has been a hot-button issue across the United States when a scandal in Minnesota gained widespread attention last fall and spreading to places like California and Ohio, the latter being the subject of a recent Daily Wire exposé examining seven medical buildings in Columbus, Ohio, that house 288 Medicaid companies and bill the government $250 million.
The key issues with Medicaid and the ease with which it can be abused both illegally and legally, according to Boliek, are the “minutia of rulemaking” that is “built in by government.”
“For example, how individual entities, whether they are a provider of clinical medical services or whether they’re a provider of daycare services or other services that can be paid for through departments of Health and Human Services, how those rules are set up and what the billing rules are,” Boliek explained.
“It really is minutiae, but in North Carolina, for exa
