OHCA suspended SoonerCare payments to Kid’s Choice Therapies, effective November 2025, and issued a notice 207 days later. The agency will not say why.
Mirabelle Care began telling families on Monday that it may no longer be able to treat their children.
The Oklahoma Health Care Authority has suspended the company’s SoonerCare payments. Mirabelle says it is close to missing payroll for 210 employees, and that in Ada, Elk City and Shawnee it is the only provider of the applied behavior analysis its patients depend on.
How Mirabelle Care Learned Its SoonerCare Payments Had Stopped
The SoonerCare payment came every Wednesday, but on June 24 it did not. Kid’s Choice Therapies called the Oklahoma Health Care Authority, then emailed, and by the company’s account no one answered for a day and a half. So Amanda Ralston, the Chief Executive Officer the new owners had installed in January, drove to the agency and sat down in the waiting room. She told the staff she was not leaving until someone explained why her company had stopped being paid.
Hours later, on June 25, she left with a letter. It was dated June 5 and addressed to an office the company says it no longer uses. Medicaid payments had been suspended, it said, because OHCA had determined that a credible allegation of fraud existed regarding the submission of claims for payment. For more than seven months, the money had kept arriving anyway.
Federal rules give a state Medicaid agency five days to tell a provider that its payments have been suspended. OHCA took 207.
The company, which rebranded as Mirabelle Care in June, says the letter was the first it had heard of any of it. Acuity reported the rebrand on June 16, eight days before the payments stopped. Since then, OHCA has refused to restore the money, and it will not say what the company is accused of. The Oklahoma Attorney General’s office says an investigation is active, but that its Medicaid Fraud Control Unit has no role in payment suspensions. The company changed hands in January, and says the conduct under scrutiny predates its ownership.
Six SoonerCare Suspension Letters, Signed in Twenty-Seven Minutes
OHCA issued six letters on June 5, one for each of the company’s SoonerCare provider numbers: 200903030A, B, C, E, F and G. Kristin Edwards, Senior Director of Program Integrity and Accountability, signed them digitally between 11:14 and 11:41 that morning. Each cites 42 C.F.R. 455.23, carries the same effective date of November 10, 2025, and contains the same sentence regarding a credible allegation of fraud in the submission of claims. None of the six says what the allegation is.
Each letter is also stamped, in bold underline at the top: BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED. Five were sent to a Norman address and one to Midwest City, all under the company’s former name, KidsChoice Therapy and Play Center. The company says none of them arrived.
The Rule Gives OHCA Five Days to Send Notice. These Letters Took 207.
Under 42 C.F.R. 455.23(b)(1), a state Medicaid agency must send notice of a payment suspension within five days of taking the action. The only exception is a written request from a law enforcement agency to withhold notice, which buys 30 days, may be renewed in writing up to twice, and, in the regulation’s words, may in no event exceed 90 days.
OHCA suspended payments effective November 10, 2025. It dated the letters June 5, 2026. That is 207 days, more than double the outer limit the rule permits, even when law enforcement requests the maximum delay.
The regulation also requires a notice that sets forth the general allegations regarding the nature of the suspension action. However, it says the agency need not disclose specifics of an ongoing investigation. The six letters state that a credible allegation of fraud exists regarding the submission of claims. They say nothing more.
What Good Cause Under 42 C.F.R. 455.23 Lets Oklahoma Medicaid Do
The rule directs a state Medicaid agency to suspend payments when it finds a credible allegation of fraud that is under investigation. It does not require the agency to keep the suspension in place, nor does it require the suspension to be total. Subsection (e) permits an agency to lift a suspension for good cause, and subsection (f) permits a partial one.
The grounds are spelled out. They include written evidence submitted by the provider, a determination that suspension is not in the best interests of the Medicaid program, and beneficiary access, where the provider is the sole community source of essential specialized services or serves a large number of beneficiaries within a federally designated medically underserved area. Subsection (f) adds another: that the allegation focuses solely and definitively on a specific type of claim or business unit, so that a partial suspension would prevent potentially fraudulent claims from being paid.
A credible allegation meets a low threshold, and the agency does not have to prove fraud to stop paying. Everything after that is discretionary, and how states use that discretion has become one of the defining pressure points in ABA, from a wave of federal Medicaid autism billing audits to retroactive recoupment demands against providers in Massachusetts.
OHCA Rejects the Good-Cause Request to Resume Payments
On June 29, Hillary K. Stuart of the Tulsa firm GableGotwals wrote to OHCA’s Legal Division on the company’s behalf. She asked the agency to resume payments and, failing that, to convert the total suspension into a partial one and release claims for dates of service on or after January 6, 2026, the day the company changed hands. The company offered to escrow or segregate everything before that date.
OHCA said no. “In exceptional circumstances, OHCA may exercise its discretion to lift a payment suspension upon a showing of good cause,” Gentry Kincade, the Authority’s Deputy General Counsel, wrote in reply. “After reviewing the information submitted on behalf of your client, OHCA has determined that no exceptional circumstance has been demonstrated that warrants lifting or modifying the current payment suspension at this time.”
Elizabeth Broomfield, Mirabelle Care Board Member, responded to the denial in a written statement to Acuity Media Network. “Our staff and families are scared and confused. Our staff is showing up every day not knowing if they’ll have jobs next month,” she said. “The families they serve may not have access to clinical services they depend on, many of whom have no other options nearby.”
OHCA’s Chief Executive and the Federal Medicaid Fraud Climate
On July 13, according to the company, Bullard telephoned its counsel to say that OHCA would not restore payments. In the company’s account of that call, Bullard said the Attorney General’s investigation includes the company as it is currently owned. However, the company says it was not told whether that refers to conduct after the January 6 sale or to the entity across both ownership periods.
The company also says Bullard told its lawyer that OHCA needed to proceed with extreme caution given the current federal push to root out Medicaid waste, fraud and abuse, pressure the company says he described as reaching the Vice President’s office. In the company’s account, that environment is a significant factor in the Authority’s decision not to restore payments. Acuity was not a party to the call and has not independently verified the account. Bullard did not respond individually, and OHCA, responding through its communications office, did not address the call.
OHCA Declines to Confirm the Investigation Its Own Letters Describe
Laura Wilcox, the Authority’s Senior Director of Communications, responded to Acuity’s request for comment stating:
“OHCA cannot clarify or identify any company as being the subject of a law enforcement investigation,” the statement said. “OHCA does not confirm, deny, or comment on the existence, scope, or details of law enforcement investigations.”
She went on to describe the framework in general terms, saying that federal Medicaid program-integrity rules require the agency to suspend payments when there is a credible allegation of fraud and an investigation is pending, unless good cause exists under the applicable federal standards. The Authority said it remains focused on serving members with integrity and accountability while safeguarding taxpayer dollars.
The Authority’s own June 5 letters are less circumspect. Each states that payments were suspended based on a determination that a credible allegation of fraud exists regarding the submission of claims. Each states that payments may be resumed if the Attorney General’s Medicaid Fraud Control Unit determines there is insufficient evidence of fraud, or once related legal proceedings are complete. The letters name the investigating body. The statement declines to acknowledge that any investigation exists.
The statement also acknowledges the discretion at the center of this dispute, noting that suspension is required unless good cause exists under the applicable federal standards. It does not say whether OHCA considered the good-cause grounds the company invoked.
The statement did not address any of the specific questions Acuity asked. It does not explain why written notice arrived 207 days after the suspension took effect, even though the rule allows five days. It does not say whether any law enforcement agency requested in writing that notice be withheld, the only mechanism in the regulation that extends that window. It does not say whether OHCA holds delivery records for the six certified letters. It does not say whether the Authority considered a partial suspension, or the beneficiary-access grounds in the rule.
Who the Medicaid Fraud Investigation Covers Is Now in Dispute
New ownership acquired the company on January 6, 2026, under a membership interest purchase agreement, with Elizabeth Broomfield serving as President. Because the deal was structured that way, the enrolled provider remained the same legal entity, billing under the same six SoonerCare provider numbers that appear on the suspension letters. Control changed completely.
The buyer group is affiliated with Aquitaine Capital, a women-owned firm and one of many private equity investors that have moved into behavioral health in recent years. Researchers counted 574 autism service sites acquired by private equity between 2015 and 2024. The buyers installed Ralston as Chief Executive Officer, added clinical leadership, retained an independent compliance consultant, engaged the accounting firm Withum to review the billing, hired a new biller, and removed the previous head biller.
KidsChoice was previously owned by Natalie Hisle, who publicly confirmed her ownership of the business to an Oklahoma City television station in 2024.
“We are doing everything right. We hired billing and compliance consultants, brought in a new management team, and have invested every dollar in systems and company improvements, and are being punished for something a prior owner allegedly did related to billing. However, no one will tell us what,” Broomfield said. “That is not justice.”
Broomfield says the compliance and billing consultants have been in place for months and have identified no material issues, and that while the new owners found sloppiness in the records they inherited, they never found evidence of widespread fraud. The company’s entire good-cause argument rests on the premise that the conduct under inquiry is pre-closing and that the current operation is not a target. Bullard’s reported statement that the investigation includes the company under current ownership runs counter to that premise, and the company says it has been given no details on what the statement means.
In Ada and Elk City, There Is No Other ABA Provider
The June 29 letter puts a number on what the closing would cost. The company runs seven clinics in Oklahoma, offering ABA, speech therapy and occupational therapy, with 288 active SoonerCare therapy enrollments: 106 in ABA, 65 in speech, 117 in occupational therapy. It employs 210 people across eight locations. The company says it serves just under 500 patients in total, with most of the remainder covered by Medicaid managed care plans rather than SoonerCare directly. The suspension notices describe the alleged fraud as concerning claims submitted to OHCA and to the Authority’s contracted entities.
In three towns, counsel wrote, there is nobody else. Ada has no other ABA provider of any kind, clinic-based or in-home, and accounts for 92 SoonerCare therapy enrollments and 37 employees. Elk City is the same, with 35 enrollments and 27 employees. Shawnee has no other clinic-based ABA provider, with 37 enrollments and 24 employees.
The business is majority Medicaid. SoonerCare accounts for roughly half of the company’s revenue, by its own account, with most of the rest coming from Medicaid managed care plans. On June 29, its lawyer wrote that without restored payment the company would miss payroll within one to two weeks, and that letter is now two weeks old.
OHCA and the Attorney General Each Point to the Other
The suspension letters themselves say the hold may be lifted and full payments resumed if the Attorney General’s Medicaid Fraud Control Unit determines there is insufficient evidence of fraud, or once related legal proceedings are complete. The letters make that unit the condition on which the money turns.
Acuity asked the Attorney General’s office about the suspension. Leslie Berger, Press Secretary for the Office of the Oklahoma Attorney General, declined to discuss the matter. “Because this is an active investigation, our office does not have any comment at this time,” she wrote. “MFCU does not have any role with regard to payment suspensions.”
Two things follow from that. The Attorney General’s office acknowledged an active investigation, which OHCA had declined to do. And the unit whose determination OHCA’s letters identify as the route out of the suspension says payment suspensions are not its business.
The company had said as much. Its lawyers were told by Charles Dickson, who runs the fraud unit, that the MFCU has no role in OHCA payment suspensions, according to the company. The Attorney General’s office has now said it in writing.
The regulation puts an obligation on OHCA in the meantime. Under 42 C.F.R. 455.23(d)(3), the state must request certification from the fraud control unit on a quarterly basis that the matter remains under investigation and that the suspension is therefore warranted. If law enforcement declines to certify, that is itself good cause to lift the suspension or narrow it.
That requirement is difficult to square with the Attorney General’s position. Either OHCA is not seeking the quarterly certifications the rule requires, or the fraud unit is providing them, in which case it has a role in whether the suspension continues. Acuity put that question to both agencies.
On July 2, according to the company, Bullard told its lawyer that Chief Operating Officer Sherri White would look into the matter herself. A call followed, and then nothing. The company says White’s out-of-office message now indicates she will not return until October 9. Acuity asked OHCA whether it has requested and received the quarterly certifications the rule requires for this suspension. The Authority did not answer.
What Happens Next in the Mirabelle Care Payment Suspension
The company is preparing to seek injunctive relief against OHCA to compel release of the suspended payments. This week it began telling families and staff where things stand.
Withheld Medicaid payments have closed ABA providers before. In June, Acuity reported that an Indianapolis ABA provider shut down after what its closure letter described as a Medicaid payment hold imposed in November 2025 over fraud allegations it said were later found to be without merit, with funds released in February. Acuity could not independently verify that account. An Indiana autism provider wound down operations entirely in February, citing payer support it could not secure.
Acuity requested comment from OHCA, including Bullard, the Authority’s Legal Division and its executive leadership, and from the Attorney General’s office. OHCA responded through its communications office with the statement above. The Attorney General’s office declined to comment on the investigation. The company’s next Wednesday remittance is due July 15.
