Seventeen Elevance Health Subsidiaries Sue The Perfect Child ABA Over Alleged Fraudulent Billing
Seventeen subsidiaries of Elevance Health (NYSE: ELV) have sued The Perfect Child ABA, its founder Simcha Bendet, and a vast network of corporations over allegations of fraudulent billing, totaling $800 million since 2021. Filed in New York state court on Wednesday, Elevance Health accuses The Perfect Child ABA of deceiving them and patient families by claiming in-network status while transferring patients to affiliated out-of-network corporations. The company then billed for these services at massively inflated rates. They also allegedly threatened families with large bills if they spoke out against the practice, according to the complaint.
Requests for comment from The Perfect Child ABA and Bendet have not been successful. Elevance Health declined to provide further comment.
Elevance Health, through its Anthem and Blue Cross Blue Shield entities, paid The Perfect Child ABA “upwards of $160,000,000.” After Elevance Health implemented pre-payment review roadblocks, the company created new, different corporations to bill under, according to the suit.
“Defendant’s course of conduct was intentional and wide-ranging,” the complaint states. “One out-of-network [corporation] even has a name that ridicules one of Anthem’s in-house investigators.”
The complaint further alleges that The Perfect Child ABA misrepresented care locations, providing clinicians, and documentation of services. It also accuses them of inappropriate upcoding and submitting the same claims from multiple corporations.
Families were often confused by the changing billing entity names but were promised immediate access to care. The Perfect Child ABA waived cost-sharing obligations to encourage treatment. In some cases, when Anthem reduced payments, Defendants sued families for the remaining fraudulent bills, amounting to hundreds of thousands of dollars, despite assuring insurance coverage.
The suit includes counts of breach of contract, breach of implied contract, common law fraud, civil conspiracy, deceptive business acts, negligence, unjust enrichment, and intentional contract interference.
The Perfect Child ABA is one of several ABA providers under scrutiny for questionable practices in the national media. It is also part of a smaller group accused of fraud. The company is reportedly under FBI investigation, as per The Wall Street Journal. Federal law enforcement has also investigated ABA Centers of America for similar out-of-network billing practices.
A parent of a child with autism treated by The Perfect Child ABA from March 2024 to October 2026 in Tennessee filed a lawsuit on Thursday. They seek class status and allege that The Perfect Child ABA charged them $102 monthly for treatment, later sending a bill for $363,816.17 for services rendered between May 19, 2026, and September 10, 2026, after Cigna denied the claims. This suit accuses The Perfect Child ABA of surprise and balance billing and violates New York business rules, two types of breach of implied contract, and unjust enrichment.