Ample Joy ABA Consulting Services has laid off dozens of staff members.
The Corona, California-based autism therapy provider laid off 100 staff. The reduction in force is expected to be permanent, according to a document from the California Employment Development Department.
Ample Joy ABA provides in-home, in-clinic, in-school and telehealth services. Its website lists clinics in Los Angeles, Corona and Palm Springs. In addition to applied behavior analysis (ABA), the company also offers early intervention, speech therapy and occupational therapy. The company was founded in 2021 by Nneka Nwani, according to a review of corporate entity and provider identification databases.
The company has not responded to a request for comment. This story may be updated.
While it’s not clear why Ample Joy ABA did these layoffs, the industry faces immense legacy problems with stagnant payer reimbursement and wage inflation, made all the worse by immense scrutiny on the autism therapy industry by the federal and state governments.
Autism therapy is a relatively new benefit for Medicaid. The last state to mandate coverage of autism therapy, Tennessee, did so in 2019. However, the last five to seven years or so have seen Medicaid spending on autism therapy services skyrocket, driven in large part by a rapid increase in the rate of diagnoses and the increased availability of ABA services, driven by private equity investment.
States were not ready for the explosive growth of the industry. This led to several states facing embarrassing audit reports showing that they improperly paid providers and failed to establish billing and documentation standards that ensure care quality and prevent fraud, waste and abuse. A series of federal audits also reveal that, across the board, the industry suffers from poor claims documentation.
States have taken rapid and sometimes dramatic action to curtail spending and establish more ground rules for billing providers. Indiana Medicaid, for example, recently established lifetime treatment hour caps, therapy-to-supervision ratios and rate cuts.
Some providers are being pushed out of markets by the new regulations and rate cuts. Autism Learning Partners announced in April that it would be halting its center expansion in New York and stop taking Medicaid patients in the state, citing looming rate cuts that would make therapy reimbursement among the lowest in the nation.
The pressure is likely to continue. At the end of April, Mehmet Oz, the administrator of the U.S. Centers for Medicare & Medicaid, said that his organization would require states to revalidate en masse providers in areas of healthcare that are deemed to be of high risk for fraud, waste and abuse. Behavioral Health Business also recently reported that Medicaid autism therapy providers in Massachusetts face a mass clawback effort by MassHealth, the state’s Medicaid entity, for services provided in 2024 if the providers’ therapy-to-supervision ratio was too low.
BHB has also tracked layoffs in other parts of the industry:
— Aliya Health Group laid off staff and closed facilities after getting new leadership
— Laurel Ridge Treatment Center, a part of Universal Health Services (NYSE: UHS), told state officials in Texas it would be laying off 648 staffers after being cut off from CMS funding.
— Alma laid off 45 staffers during the interim between the announcement and the closing of its acquisition by Spring Health.