Florida’s Medicaid crackdown has driven a nearly $1 billion drop in projected behavioral therapy spending after investigators found providers billing more than 24 hours in a single day.
State officials say the integrity push stopped suspicious claims before the money went out the door, and the projected savings are already showing up in next year’s budget numbers.
Fox News reported that Florida’s Agency for Health Care Administration terminated more than 220 Medicaid providers for fraud, waste, or abuse, restricted or suspended payments to more than 260 others, and referred more than 150 suspected fraud cases to the attorney general’s office over the past year. The same enforcement wave is tied to a nearly $980 million reduction in projected annual spending on Applied Behavior Analysis services alone, the intensive therapy often used for children with autism and related conditions.
Gov. Ron DeSantis framed the results as proof that Florida stopped waiting for Washington to clean up the program.
"This year, we announced the most significant Medicaid integrity initiative in the history of our state, and today, I was proud to announce some of the results from these efforts,"
DeSantis said in a news release tied to the announcement.
Investigators found billing that defied basic math. Some providers charged Medicaid for more than 24 hours of services in a single day, claims that could not describe real care delivered to real patients.
The governor’s office said annual Medicaid spending on Applied Behavior Analysis had been projected to hit $3.86 billion. After the crackdown, fraud enforcement, managed care controls, and utilization management, that figure is now expected to total $2.88 billion in fiscal year 2026-27. Officials put the reduction at nearly $980 million.
That is not a rounding error. It is nearly a billion dollars in taxpayer money that was on track to leave the program, money Florida says will no longer flow to schemes built on impossible schedules and weak gatekeeping.
AHCA Secretary Shevaun Harris put the mission in plain terms.
"Protecting Medicaid means protecting the people it was created to serve,"
Harris said, adding that children, pregnant women, the disabled, and seniors need high-quality care without watching dollars vanish to fraud or abuse.
"AHCA will continue taking decisive action to strengthen program integrity, hold bad actors accountable and safeguard these critical services for Floridians,"
she said.
Florida’s approach breaks from the old habit of paying first and chasing thieves later. The DeSantis administration moved to stop suspicious claims before payment, expand monitoring, and harden enrollment so bad actors never get a provider number in the first place.
Since January 2026, AHCA has issued more than 1,000 adverse decisions on Medicaid provider enrollment or re-enrollment. The agency has also conducted 400 site visits, including in high-risk categories such as Applied Behavior Analysis, medical equipment, and adult day care. Enrollment moratoriums hit certain high-risk provider types. A pilot with identity-verification firm SentiLink screens for stolen or fake identities and hidden ownership structures.
AHCA told Fox News Digital the problem is not Florida’s alone.
"Medicaid fraud is a national problem, and it is growing more sophisticated everywhere,"
the agency said. It added that Florida is not waiting for instructions: prevent fraud at the front door, verify every provider, and follow the data, and that a fraudulent provider stopped in Florida is a scheme that does not simply relocate to the next state. Florida also said it welcomes partnership with the Centers for Medicare & Medicaid Services and other states.
Harris spoke on the crackdown at a news conference Oct. 6, 2026, at the Health Care District of Palm Beach County. DeSantis had earlier addressed related integrity work at a press conference in Miami on April 10, 2025.
The same reporting placed Florida’s results against a wider federal fight. HHS Secretary Robert F. Kennedy Jr. has put a $1 billion Medicaid freeze on California and Minnesota over suspected fraud, aligning with the call to move away from traditional “pay-and-chase” models that Florida says it already discarded.
California Gov. Gavin Newsom rejected the allegations, calling them “pure politics” and blaming the Trump administration. Minnesota faces heightened federal scrutiny and payment reviews. The reporting also stated that Gov. Tim Walz’s approval rating plummeted 31 points after a fraud investigation.
Those fights are not abstract. Medicaid is a joint state-federal program funded by taxpayers. When providers bill for hours that do not exist, or when enrollment checks fail, the bill lands on workers and families who never consented to subsidize the scam. Florida’s numbers show what happens when a state treats that as a policing problem instead of a paperwork problem.
The Florida figures are concrete: more than 220 terminations, more than 260 payment restrictions or suspensions, more than 150 referrals to prosecutors’ offices, more than 1,000 adverse enrollment decisions, 400 site visits, and a projected nearly $1 billion correction in one service line. The mechanism is also concrete, identity screening, site visits, moratoriums on high-risk categories, and refusal to pay claims that cannot be true.
Other states can keep arguing about motives. Florida published results. Providers who billed more than a full day of care in 24 hours were not delivering a public service; they were testing whether anyone was watching. Tallahassee answered that test with terminations, freezes, and referrals.
Harris’s agency stated the stake without spin: safeguard critical services for people who need them, and stop losing taxpayer dollars to fraud and abuse. That is the baseline voters expect from any government that claims to run a safety-net program.
When states refuse to verify providers and federal overseers finally hit the brakes, the political blame game starts fast. The billing records still have to add up to 24 hours or less.
