The central dispute for the Messier family is a $1.48 million bill for in-home therapy provided to their 15-year-old daughter, Sophia Finocchio, who has Down syndrome, nonverbal autism, and significant developmental needs. The family says the provider ended her services the same day a television crew visited their home.
Sophia began in-home applied behavior analysis therapy through The Perfect Child in July 2025 and made noticeable behavioral strides, according to WSMV. Records reviewed by the station showed charges of roughly $10,000 for a single three-hour session, with some days reaching $20,000 through apparent double billing. ABA therapy is widely considered the gold-standard treatment for children with autism, though access can be complicated by provider shortages in rural areas and insurance reimbursement rules.
The collection demand, as described by WSMV, offered the family two options: sign a limited power of attorney allowing the company to pursue insurance recovery directly, or remain personally liable for the full $1.48 million balance. The letter was signed by a lawyer with the surname Bendet. Kiersten Messier told the station she feared the dispute could end up in court. The Perfect Child terminated Sophia's therapy the day WSMV4 visited the family's home.
A Pattern Beyond One Family
WSMV reported that other Tennessee families received bills from The Perfect Child ranging from $364,000 to nearly $1.5 million. Jason Elkins, whose daughter attended the company's Clarksville program for three years, said the family had initially been told its out-of-pocket cost would be about $102 a month after insurance. After the insurer began denying claims, the company billed the family more than $364,000. The Elkins family is part of a planned class-action lawsuit with a New York City law firm; lawyers told the station it should be filed the week of November 4.
WSMV reported that claims were submitted under several business names and identified Simcha Bendet as The Perfect Child's executive director. Neither Bendet nor the company responded to the station's phone and email requests for comment.
Federal and Congressional Scrutiny Mounts
The billing practices have drawn attention well beyond Tennessee. The FBI's Pittsburgh field office is investigating how The Perfect Child bills for autism therapy services, according to Quartz, which reports that in October the bureau collected company records including billing statements and other paperwork. The company was still in operation and still sending bills to clients at the time of that report.
Congress has also been circling the company. The House Committee on Education and Workforce wrote to The Perfect Child in July requesting records on how it bills clients and collects payment, the same outlet notes. In August, the U.S. House Committee on Education and the Workforce sent Simcha Bendet a formal inquiry concerning the company's healthcare pricing practices, citing unusually large insurance claims and prior Wall Street Journal reporting, according to WSMV. WSMV4 Investigates says it plans to share its findings with congressional investigators and continue tracking the case.
A similar story played out with a different family in New Jersey. Mother Carolina Lopez said the company promised immediate therapy for her son with no out-of-pocket costs, but she received an invoice for $911,400 in April, according to Yahoo Finance. Records in her case showed a provider billed her insurer $30,500 for a day when her son received just 70 minutes of therapy.
A Booming — and Increasingly Scrutinized — Industry
The billing disputes arrive amid explosive growth in autism-therapy spending nationally. Spending on applied behavior analysis climbed from $2 billion in 2021 to $10 billion in 2025, Quartz reports, citing a federal analysis. Separately, annual spending on hands-on autism therapy among roughly 40 large employers covering 3.5 million people doubled over that same period, reaching $108 million, according to claims data analyzed by the Health Transformation Alliance and cited by Yahoo Finance.
Aetna has reported that investigations uncovering likely fraud or abusive billing by autism-therapy providers jumped 300% between 2024 and 2025 and could rise another 50% in 2026, per the same Yahoo Finance report. The number of registered behavior technicians nationwide rose from about 96,000 in 2019 to roughly 535,000 by the end of 2025, the outlet notes, citing a Wall Street Journal analysis of federal provider data.
Government payers have felt the strain as well. Medicaid and CHIP spending on ABA increased 421% between 2021 and 2025, outpacing growth in the number of children with autism diagnoses receiving services, according to a report cited by Eye on Enforcement. In response, the Centers for Medicare and Medicaid Services released a 173-page ABA toolkit aimed at helping states tighten oversight of billing practices in the sector.
CMS reported that Medicaid and CHIP spending on ABA rose 421% between 2021 and 2025, while the number of children with an autism spectrum disorder diagnosis receiving services grew 67%. The agency issued its ABA toolkit in August 2026 to guide states in strengthening billing oversight, but says it creates no new federal requirements and does not direct states to limit access to medically necessary care, according to the Centers for Medicare & Medicaid Services. Those program-wide figures do not establish wrongdoing by any provider.
A separate Connecticut case resulted in a settlement: Attorney General William Tong announced on July 2, 2026, a $710,815.34 agreement with defunct autism-services provider Trading Spaces ABA, LLC, and its owner, resolving allegations of false Medicaid billing for services not provided, according to the U.S. Department of Health and Human Services Office of Inspector General. That was a separate case and is not a finding about The Perfect Child.
The rapid growth of ABA spending has also drawn scrutiny to the role of private investment in the field. Blackstone's 2018 buyout of the Center for Autism and Related Disorders was followed by the closure of more than 100 sites within four years and the company's bankruptcy by June 2023, according to a report from the Center for Economic and Policy Research. For families like the Messiers, the immediate concern remains more personal: a daughter whose therapy was abruptly cut off, and a $1.48 million demand that, as of publication, remains unresolved.
