ABA Centers of America Lawsuits: Publix RICO and Point32Health Fraud

ABA Centers of America is fighting billing fraud allegations on two fronts: a Massachusetts case with Point32Health, where a $19 million counterclaim accuses the autism therapy provider of systematic fraud, and a Florida federal RICO suit brought by Publix Super Markets alleging a $15 million scheme. The company has denied wrongdoing. Both cases remain pending as of 2026, and a third major payer, Optum, has ended its relationship with the provider. The lawsuits against ABA Centers of America sit inside a broader wave of insurer scrutiny of the ABA therapy industry.

Who ABA Centers of America Is

Christopher Barnett founded ABA Centers of America in December 2020 to provide Applied Behavior Analysis therapy for children with autism, offering both in-clinic and in-home sessions.¹²³ Jason Barker was named CEO in September 2024.⁴

The Point32Health Case in Massachusetts

ABA Centers filed first. On December 31, 2024, it sued Point32Health and its subsidiary Harvard Pilgrim Health Care in Suffolk County Superior Court, seeking $80 million.⁵ The complaint accused Point32Health of “payer ghosting,” alleging the insurer had placed thousands of claims on “pend status” without formally denying them or contesting medical necessity, and had paid nothing since December 2023. It also alleged Point32Health ran a “ghost network” with an inaccurate provider directory, and said ABA Centers had to keep treating patients out-of-network because in-network options were not actually available.⁶

The $19 Million Fraud Counterclaim

Point32Health responded on November 12, 2025 with a 49-page counterclaim accusing ABA Centers of “systematic billing fraud” and seeking more than $19 million.⁷ Tufts Associated Health Maintenance Organization and Health Plans, Inc. joined as additional counterclaim plaintiffs.

The specific allegations included:

Billing more than $137,000 for movie screenings of “A Bug’s Life,” “Bee Movie,” and “Super Mario Brothers,” plus a trampoline park outing, as ABA therapy sessions.⁷
Upcoding a $1.9 million claim for a single patient under a specialized code requiring an on-site physician and documented destructive behavior, allegedly with neither present. Point32Health said ABA Centers acknowledged the error in July 2024 but refused to repay.⁷
Using “Diagnostic Technicians,” a title the filing said matches no recognized credential, to conduct autism evaluations, with staff psychologists then signing off on up to 80 assessments a week without meeting patients. The insurer said later clinical reviews found some inaccurate diagnoses.⁷
Deliberately staying out-of-network to charge up to 2,015 percent above standard in-network fees, requiring employees to de-credential from the network, and coaching staff to manufacture evidence that in-network providers were unavailable.⁷
Offering families $1-per-month payment plans that effectively waived cost-sharing while telling the insurer those amounts had been collected. Point32Health said this could violate Massachusetts kickback law.⁷
Billing at least $1.4 million for school-based services, which the plan excludes, by listing the service location as “community.”⁷
Sorting patients internally into “super payer,” “mid-range payer,” and “scholarship payer” tiers, with lowest-tier patients facing discharge if profitability thresholds went unmet.⁷

The counterclaim brings nine counts, including fraud, fraud in the inducement, violations of Massachusetts insurance and consumer protection laws, tortious interference, negligence, unjust enrichment, and breach of contract. Point32Health also seeks treble damages and attorneys’ fees.⁷ Both the original suit and the counterclaim remain pending.⁸

The Publix Cases in Florida

ABA Centers and Publix Super Markets are in litigation with each other in two courts. The dispute involves therapy provided to children of Publix employees under the chain’s self-funded plan.

ABA Centers’ State Suit

On August 25, 2025, ABA Centers of Florida (doing business as ABA Cares) sued Publix in the 17th Judicial Circuit Court in Broward County. The complaint alleged Publix had refused to pay for pre-authorized therapy provided to ten children, ages 4 to 17, since October 2024, with authorizations issued by the plan administrators, Blue Cross Blue Shield of Florida and Blue Cross Blue Shield of South Carolina. ABA Centers seeks full payment, 12 percent annual interest, and attorneys’ fees, and says it continued treatment to avoid disrupting care.⁹

Publix’s Federal RICO Suit

Publix sued the same day in federal court. Judge Kathryn Kimball Mizelle dismissed the initial complaint as an impermissible “shotgun pleading.”¹⁰ Publix refiled with a 221-page amended complaint. The case was transferred to the Southern District of Florida in October 2025 and assigned to Judge William P. Dimitrouleas, brought under RICO.¹¹

Publix alleges a $15 million fraud scheme, claiming ABA Centers:

Billed for services that never happened or were not plan-covered.
Submitted duplicate payment requests for the same sessions.
Failed to collect the 40 percent out-of-pocket share from families while telling the plan that patients had met deductibles and out-of-pocket maximums. The filing said patients paid “not even $1” toward these obligations.¹⁰
Charged as much as $990 per 15-minute increment, or roughly $4,000 per hour, against a network average of $21.90 per 15 minutes.⁹

Publix said it paid at least $5.8 million to the provider over the two years ending in October 2024 before detecting what it calls the fraud.¹⁰ ABA Centers filed a motion to dismiss in November 2025. As of April 2026, Judge Dimitrouleas had not ruled, and no trial date is set.¹¹

Optum Cutoff and Layoffs

In June 2026, ABA Centers began telling families with Optum-managed coverage that services would end effective June 5, 2026. People in the autism care community described the roughly two-week notice as unusually short. An unofficial company source said Optum had determined ABA Centers could no longer serve certain members and that the company was transitioning affected patients elsewhere. Optum’s reasoning and the number of families affected have not been publicly confirmed.⁸

Layoffs followed. Reported on June 12, 2026, they were tied to lost Optum revenue. The company would not say how many jobs or which sites. A spokesperson said ABA Centers “regularly evaluate[s] organizational needs and make[s] adjustments as necessary” and that “growth, client demand, and operations remain on track.”¹²

Why This Is Happening Now

ABA Centers is one visible case in a wider clash between fast-growing autism therapy providers and the insurers paying their bills. Rising diagnoses and state coverage mandates have pushed ABA into a multibillion-dollar industry, and payer scrutiny has followed. Aetna said its internal investigations flagging likely fraud or abusive billing by ABA providers rose 300 percent between 2024 and 2025, with a further 50 percent increase projected for 2026.¹³

State audits have found large sums of improper Medicaid ABA payments across the industry, including $77.8 million in Colorado for 2022–2023 and over $16.7 million in Massachusetts overpayments to 108 providers for inadequately supervised services, some involving claims for more than 24 hours in a single day.¹⁴ North Carolina’s Medicaid ABA spending rose from $1.9 million in 2020 to over $505 million in 2025, and Attorney General Jeff Jackson confirmed active investigations into ABA billing.¹⁵ The ABA Centers litigation is the highest-profile flashpoint in that larger fight.

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Temple University College of Public Health. Christopher M. Barnett
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