MAC Midwest Testifies Before the Minnesota Health and Human Services Committee

On Wednesday, March 10, 2026, Jen Diederich, Chief Compliance Officer at MAC Midwest, testified before Minnesota’s Health and Human Services Committee about proposed policy changes that could significantly impact autism therapy providers across the state.

Jen spoke on behalf of MAC Midwest and alongside members of the Autism Treatment Association of Minnesota (ATAM), representing providers and families who rely on Minnesota’s Early Intensive Developmental and Behavioral Intervention (EIDBI) program.

EIDBI services provide medically necessary therapy for children and young adults diagnosed with autism. For many families, these services are life-changing. They help children build communication, social, and daily living skills that support greater independence and safety.

But right now, the system that delivers these services is under strain.

In her testimony, Jen outlined several concerns about proposed requirements that could unintentionally destabilize autism treatment providers across Minnesota.

The Children We Serve

The individuals served through EIDBI are among Minnesota’s most vulnerable. These are children and young adults with medically diagnosed autism who rely on specialized therapy to build foundational life skills.

For many families, autism therapy is not simply helpful, it is essential. In some cases, children come to treatment after schools or other programs have referred them out due to safety concerns or an inability to meet their needs.

Without access to therapy, families often have very few options left. In the most difficult cases, the only remaining alternatives can be emergency rooms or medical crisis units.

That is why maintaining a stable system of autism providers matters so deeply to the families we serve.

The Current Environment is Already Strained

Autism providers across Minnesota are currently navigating significant financial and operational pressure.

New auditing and payment review systems have created delays and uncertainty around when providers will be reimbursed for services that have already been delivered. For organizations operating on thin margins, these delays can quickly create serious cash flow challenges.

For example, as of Jen’s testimony, MAC Midwest had approximately $3 million in Medicaid claims awaiting payment, with $1.4 million already more than 30 days overdue. In addition, the collapse of UCare left providers with hundreds of thousands of dollars in unpaid claims.

Across the field, providers are experiencing similar challenges.

This environment has already pushed many organizations to the edge.

Proposed Financial Requirements Could Make Things Worse

The proposal currently under discussion would require certain providers to maintain 90 days of cash reserves or secure a surety bond.

While the intent is to protect program integrity, the reality is that these requirements could create serious barriers for nonprofit and community-based providers.

Unlike large national companies backed by private equity, many Minnesota providers are small or midsized nonprofits. They operate with limited margins and reinvest resources directly into care for families.

Even securing a basic line of credit can be difficult.

When the current prepayment review process began, MAC Midwest approached multiple banks to secure a financial safety net. Five traditional banks declined. Three alternative lenders were also approached before the organization was finally able to secure a line of credit, and even that came with significant fees.

For many providers, adding the additional requirement of a surety bond would simply not be feasible.

The result would not be stronger program integrity. It could instead lead to fewer providers and reduced access to care for families.

The Real Issues Need to Be Addressed

Jen also highlighted that a surety bond requirement would not solve the issues that are currently causing delays and instability in the system.

Providers across the state are experiencing:

• Incorrect claim suspensions

• Inconsistent interpretations of policy

• System errors and glitches

• Delays caused by automated claim review processes

• Enrollment delays that can prevent providers from being paid for 30, 60, or even 90 days

These issues create financial penalties for providers who are delivering legitimate services but have little control over the systems processing their claims.

Addressing these operational challenges would do far more to stabilize the system than adding additional financial barriers.

Accountability Already Exists

Minnesota already has mechanisms in place to ensure accountability within the EIDBI program.

When fraud or misconduct occurs, responsibility rests with the Qualified Supervising Professional (QSP) overseeing services. The state has clear authority to address issues through:

• Professional licensing boards

• Credential suspension or revocation

• Site visits and audits

• Program revalidation and oversight

Strengthening these existing mechanisms provides a more targeted and effective way to protect program integrity than imposing broad financial requirements on entire organizations.

A Shared Goal: Protecting Access to Care

At MAC Midwest, we fully support the state’s goal of ensuring strong oversight and program integrity.

At the same time, it is critical that new policies do not unintentionally reduce access to care for the children and families who depend on these services.

For nearly 30 years, MAC Midwest has worked to support individuals with autism and their families through compassionate, high-quality care. Our mission is simple: to foster ability and agency in every individual we serve.

Policies that support provider stability ultimately support families.

And together, we can ensure that Minnesota remains a place where children with autism and their families can access the care they need, today and for the next 30 years.