In a major development that puts the spotlight on oversight and accountability in autism care, the Massachusetts Attorney General’s Office (AGO) announced indictments against Patrice Lamour and her two Randolph-based companies—Lamour by Design (LBD) and Lamour Community Health Institute (LCHI)—for allegedly defrauding the state’s Medicaid program, MassHealth, of over $1 million.

These indictments stem from accusations that Lamour and her businesses submitted false claims for Applied Behavioral Analysis (ABA) services—an essential therapy for children with autism spectrum disorder (ASD)—that were either never delivered or fraudulently documented. According to the charges, both LBD and LCHI, under Lamour’s direction, fabricated service records and billed MassHealth for care that never occurred, including on holidays, canceled sessions, and even after clients had discontinued services.

What’s particularly troubling is the specific manipulation of ABA service billing. ABA therapy, which uses behavioral principles to promote positive changes in behavior, typically involves a mix of direct care from behavioral technicians and oversight from Licensed Applied Behavioral Analysts (LABAs). But according to the AGO, the only LABA on LBD’s staff was part-time and admitted to not performing the services that were billed under his name.

It didn’t stop there. Employees at LBD and LCHI were allegedly instructed to falsify records, billing sessions using historical data rather than real-time documentation. Essentially, the companies were retroactively inventing care to generate income from MassHealth.

Each defendant—Lamour, LBD, and LCHI—faces one count of Medicaid False Claims and one count of Larceny over $1,200. These are serious charges that come with substantial potential penalties. Of course, it’s important to note: these remain allegations, and all defendants are presumed innocent until proven guilty in a court of law.

This case is part of a broader crackdown by the AGO on fraudulent ABA billing practices. Back in February, a man in Essex County was convicted of stealing more than $33,000 in a similar scheme. And in October 2023, the AGO recovered $2.5 million through settlements with other ABA providers accused of submitting improper claims—some performed by unqualified personnel or entirely undocumented.

The investigation leading to these latest indictments was a coordinated effort. Assistant Attorneys General Katie Davis and Sean Hildenbrandt, along with investigators from the AGO’s Medicaid Fraud Division, led the charge, with key support from MassHealth, its managed care entities, and the Department of Public Health.

It’s worth highlighting that the AGO’s Medicaid Fraud Division—certified annually by the U.S. Department of Health and Human Services—is not only tasked with rooting out financial fraud but also investigates abuse, neglect, and exploitation within the Medicaid system, especially in long-term care facilities.

The division itself is 75% federally funded, with nearly $6 million allocated for federal fiscal year 2025. The remaining 25% is covered by the Commonwealth of Massachusetts.

For those concerned about similar issues or who wish to report potential Medicaid fraud, the AGO encourages people to file a complaint through its website. The case serves as a sharp reminder that vulnerable populations, including children with autism, deserve both quality care and honest providers, and that systems meant to support them must be protected from exploitation.

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