Seventeen subsidiaries of Elevance Health (NYSE: ELV) have sued The Perfect Child ABA, its founder Simcha Bendet and a massive network of corporations over allegations of fraudulent billing where the alleged charges total $800 million since 2021.
Filed in New York state court on Wednesday, Elevance Health says The Perfect Child ABA deceived Elevance Health and patient families by claiming the company was in-network with the payer but then transferring patients to corporations affiliated with the company that were out-of-network. The company then billed out-of-network services for massively inflated prices. It then threatened patients’ families with massive bills if they spoke out against the practice, according to the complaint.
Requests for comment to The Perfect Child ABA and Bendet have not been returned. 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 established pre-payment review roadblocks to curb abnormal behavior, the company alleges that The Perfect Child ABA created new and different corporations to bill under.
“Defendant’s course of conduct was intentional and wide-ranging,” the complaint reads. “One out-of-network [corporation] even bears an absurd name that mocks one of Anthem’s in-house investigators.”
The complaint further alleges that The Perfect Child ABA misrepresented the location of care, the providing clinician and the documentation of underlying services. It also alleges inappropriate upcoding and submitting the same claim from several different corporations.
Families were often confused by the changing names of the billing entities but were promised immediate access to care. The Perfect Child ABA also waived cost-sharing obligations to induce treatment.
“In some cases where Anthem took steps to reduce payments, Defendants went so far as to file suit against families for the remainder of the fraudulent bill of hundreds of thousands of dollars—all for services they had told families would be covered by insurance,” the complaint states.
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 among several ABA providers who have faced withering coverage for questionable practices in the national media. It is also among a much smaller subset that have been accused of fraud. The company is also allegedly under investigation by the FBI, according to reporting by The Wall Street Journal. Federal law enforcement have investigated ABA Centers of America, which practiced a similar out-of-network model and is also facing legal accusations of fraudulent billing that exploited the present payer paradigm on the federal and state level.
The Perfect Child ABA and Bendet were also sued in federal court by a parent of a child with autism that was treated by the company from March 2024 to October 2026 in Tennessee. That suit was filed on Thursday.
The parent is seeking class status for the case. They allege in the suit that The Perfect Child ABA would charge them $102 a month for treatment. After Cigna, the family’s insurer, started denying claims, the company sent the parent a bill for $363,816.17 for service rendered between May 19, 2026, and September 10, 2026. That suit names six The Perfect Child ABA corporations.
This suit alleges that the company is practicing surprise and balance billing. Specifically, alleges that The Perfect Child ABA engaged in unlawful trade practices in New York business rules, two types of breach of implied contract and unjust enrichment.
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