São Paulo Police Raid Autism Clinics in Probe of Alleged Health-Plan Fraud

Overview

• Detectives from the state criminal investigations unit executed 12 search-and-seizure warrants in São Paulo and its metro area as part of an inquiry into fraud against three health insurers.
• Police say the clinics faked visits, issued false medical reports, and filed lawsuits to force plans to pay for treatments that did not happen or were billed at inflated prices.
• Abramge, which represents health plans, reports one clinic alone may have caused about R$17 million in losses and says total exposure could approach R$60 million.
• Investigators cite unusual charges that reached R$50,000 a month and demands for eight hours a day of therapy, with some bills topping R$200,000.
• Authorities say some children were misdiagnosed and put into unsuitable therapy, and they are now reviewing seized records to identify all involved and calculate the full damage.