Florida’s Medicaid integrity push has cut nearly $1 billion in projected behavioral therapy spending after officials caught providers billing more than 24 hours in a single day, while federal freezes now hit California and Minnesota over the same waste.
Gov. Ron DeSantis’s administration says its statewide Medicaid crackdown has already forced a sharp reversal in one of the program’s fastest-growing costs. Projected annual spending on Applied Behavior Analysis therapy, once headed for $3.86 billion, is now expected to total $2.88 billion in fiscal year 2026-27.
That nearly $980 million reduction, state officials report, stems from fraud enforcement, managed care controls, and utilization management after providers were found billing for impossible hours and other abuse. The results land as HHS Secretary Robert F. Kennedy Jr. holds more than $1 billion in federal Medicaid funds to California and Minnesota over suspected fraud.
Fox News reported the Florida figures alongside the broader federal pressure campaign, framing Tallahassee’s approach as a working model rather than another pay-and-chase cleanup.
Florida officials say the crackdown started at the front door. Instead of paying first and hunting stolen money later, the Agency for Health Care Administration expanded monitoring, site visits, and enrollment screens meant to stop suspicious claims before taxpayer dollars go out.
That shift mirrors Kennedy’s call to abandon traditional “pay-and-chase” models. In Florida, the numbers show what happens when the state actually does it.
More than 220 Medicaid providers have been terminated for fraud, waste, or abuse. More than 260 others face payment restrictions or suspensions. Over the past year, officials referred more than 150 suspected fraud cases to the attorney general’s office.
Since January 2026, the agency has issued more than 1,000 adverse decisions on provider enrollment or re-enrollment and conducted 400 site visits. Those visits focused on high-risk categories, including ABA therapy, medical equipment, and adult day care.
Among the red flags: providers who billed for more than 24 hours of services in a single day. You cannot deliver more care than there are hours on the clock. Florida treated that as a billing problem worth stopping, not a paperwork glitch worth reimbursing.
DeSantis tied the results to what he called the most significant Medicaid integrity initiative in state history.
In a news release, DeSantis said:
"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,"
AHCA Secretary Shevaun Harris cast the effort as protection for the people Medicaid was built to serve, not a war on the program itself.
"Protecting Medicaid means protecting the people it was created to serve,"
Harris continued:
"For children, pregnant women, the disabled, and our seniors, it means making sure they have access to high-quality care while ensuring taxpayer dollars are not lost 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,"
Florida did not stop at claim reviews. AHCA launched a pilot with identity-verification firm SentiLink to screen for stolen or fake identities and hidden ownership structures among Medicaid providers. The state also placed enrollment moratoriums on certain high-risk provider categories.
AHCA told Fox News Digital the problem is national and getting more sophisticated. Florida’s answer, the agency said, is to verify providers, follow the data, and keep fraudulent operators from simply packing up and moving to the next state.
"Medicaid fraud is a national problem, and it is growing more sophisticated everywhere,"
The agency added:
"Florida is not waiting to be told what to do. We are building the model: prevent fraud at the front door, verify every provider, and follow the data. We welcome partnership with CMS and other states, because a fraudulent provider stopped in Florida is a scheme that does not move on to the next state."
That is the opposite of the soft posture taxpayers have watched for years: pay the claim, shrug at the audit backlog, and hope recovery letters arrive after the money is gone.
While Florida advertises prevented spending, the Trump administration’s HHS is holding federal dollars to two blue states until they prove the claims are clean. Kennedy announced the deferral of over $1 billion in federal Medicaid payments to California and Minnesota amid suspected fraud and waste.
CMS is holding more than $867 million for California and more than $200 million for Minnesota while it reviews high-risk claims. Those reviews cover in-home services and payments tied to deceased beneficiaries or unsatisfactory immigration status. The hold continues until the states substantiate prior-quarter claims.
The New York Post reported Kennedy’s line on the freeze:
"We are not sending Medicaid dollars out the door until we have confidence that they are being spent lawfully and appropriately,"
Kennedy went further on the political choice he says Democratic leaders made:
"Instead of protecting your money, they open the floodgates to theft. They dismantle basic program integrity and oversight."
In California, in-home services spending rose 24% over two fiscal years, against a 12% national average. Frozen funds there include $221 million linked to individuals of unsatisfactory immigration status and claims for services after death. In Minnesota, officials flagged 14 high-risk areas for vulnerabilities or evidence of fraud. Heightened federal scrutiny, including investigations and payment reviews, has already put Minnesota under the microscope.
California Gov. Gavin Newsom rejected the allegations as “pure politics” and blamed the Trump administration. Minnesota Gov. Tim Walz has faced his own political fallout; his approval dropped 31 points after a fraud investigation, according to the Fox News lead.
Newsom’s answer is the familiar one from leaders caught defending weak controls: call the audit partisan, keep the faucet open, and treat oversight as an attack. Florida’s numbers suggest another option, terminate the bad actors, lock the enrollment door, and stop impossible bills before they clear.
Medicaid was built for children, pregnant women, people with disabilities, and seniors. It was not built to reimburse clinics for 25-hour days, pay for care after a beneficiary dies, or underwrite schemes that hop from state to state when one regulator finally notices.
Florida’s projected ABA spending drop of nearly $1 billion did not require a new slogan. It required site visits, enrollment denials, payment suspensions, and referrals to prosecutors. More than 220 terminations and more than 150 AG case referrals are not press-release decoration. They are the mechanics of a system that decided fraud is a gatekeeping problem, not a recovery problem.
Kennedy’s freeze on California and Minnesota applies the same logic with federal leverage: substantiate the claims or wait for the money. One state shows what aggressive integrity work can save on paper. Two others are being told the blank check is closed until they do the same.
Taxpayers do not owe endless tolerance for impossible billings and dead-beneficiary claims. Leaders who protect the program’s integrity protect the patients who actually need it, and the public that funds it.
