Florida Projects Nearly $1 Billion Less in Medicaid Autism-Therapy Spending

Gov. Ron DeSantis said Tuesday that Florida’s Medicaid integrity push has cut projected spending on Applied Behavior Analysis services by nearly $1 billion for the coming fiscal year.

The Agency for Health Care Administration had projected ABA spending, the therapy billed for children with autism, at $3.86 billion. After the state moved those services into managed care, tightened utilization review, and stepped up fraud enforcement, the projection for fiscal year 2026-27 is $2.88 billion. The difference is $980 million. The governor’s office tied the drop to the managed-care shift, utilization management, and the fraud work together, not to the terminations alone.

AHCA Secretary Harris said Florida Medicaid paid about $6.57 billion for ABA between 2023 and 2025, nearly four times any other state program, and had been on a path of about 30 percent year-over-year growth. “To say that we’re an outlier is an understatement,” Harris said. “That kind of growth is unsustainable.”

DeSantis announced the integrity initiative in June and described it as a move off the old “pay-and-chase” model, in which the state paid claims and tried to recover bad ones later. AHCA tightened provider screening, expanded claims monitoring, froze enrollment in some high-risk categories, and started a statewide revalidation of active Medicaid providers. Since January the agency has made more than 400 provider site visits, with extra attention on ABA, durable medical equipment, and adult day care.

The governor’s office reported more than 150 referrals to the attorney general over the last year on fraud allegations, more than 260 providers placed on payment restrictions or suspended, and more than 220 providers terminated for fraud, waste, or abuse. The terminated providers billed more than $230 million to Medicaid in 2025. The Center Square, citing the Tuesday announcement, put that billing figure above $250 million and said the referrals, restrictions, and terminations had come since June. The governor’s release uses the lower billing number and the longer window.

Investigators described billing for excessive hours, including claims that ran for months of consecutive days through weekends and holidays. Harris told providers misusing the program, “In my opinion, you’re a predator and we’re going to treat you as such.” Florida also stood up an Applied Behavior Analysis Task Force this year to tighten accountability inside the benefit.

The $980 million is a change in the projection, not cash already recovered. The terminated providers’ $230 million is what they billed in 2025, not a confirmed restitution total. DeSantis said the point of the remaining work is to keep the benefit for eligible children while the state stops paying claims that do not survive a site visit.