DeSantis Says Florida Has Cut 220 Medicaid Providers and Sent 150 Fraud Referrals as Crackdown Expands

Florida has terminated more than 220 Medicaid providers for fraud, waste or abuse and sent more than 150 fraud referrals to the Attorney General's Office over the past year, Gov. Ron DeSantis said Tuesday, Oct. 6, as he released the first results of the state's Medicaid integrity initiative at the Health Care District of Palm Beach County in West Palm Beach. The terminated providers accounted for more than $230 million in 2025 Medicaid billing, according to the governor's office, and the state now projects nearly $1 billion less in annual spending on applied behavior analysis, the autism therapy that has become one of the program's fastest growing costs.

DeSantis described the numbers as "kind of just the opening salvo" and said he expects "more results coming in the weeks, months and years ahead," WPTV reported. The announcement comes seven months after the federal Medicaid agency singled out Florida as a fraud hotspot, and four months after the state launched a statewide revalidation of every active Medicaid provider.

The numbers the state released

The Agency for Health Care Administration, which runs Florida Medicaid, reported the following results from its expanded program integrity work.

The site visits focused on three categories the state considers high risk: applied behavior analysis (ABA) for people with autism, durable medical equipment and adult day care. AHCA has also imposed enrollment moratoriums on some high-risk provider types, including durable medical equipment suppliers and adult day care providers, pausing new enrollment while screening is tightened.

What investigators say they found

State officials cited billing patterns they described as red flags, including providers billing for consecutive days of service through every weekend and holiday for months, and some billing Medicaid for more than 24 hours of services in a single day. AHCA Secretary Shevaun Harris also described theft of Medicaid identification numbers to submit false claims.

"Claims do not submit themselves," Harris said, according to WJXT. "It takes action and intention." She said the agency wants Medicaid money going to patients, "not in the pockets of crooks," WPTV reported.

"Medicaid dollars must go to healthcare for eligible Floridians, not to people who are gaming the system," DeSantis said.

The state has not released a list of the terminated providers. Harris told WPTV she would share what she could without jeopardizing ongoing investigations, some of which may be criminal.

The ABA spending surge and the move to managed care

The largest dollar figure in the announcement involves ABA therapy. Harris said Florida Medicaid paid about $6.57 billion for ABA from 2023 through 2025, nearly four times what any other state's Medicaid program spent, and spending had been projected to grow about 30% a year, WPTV reported.

Florida moved ABA services into Medicaid managed care in 2025, shifting prior authorization, provider contracting and payment to the private health plans that run most of the program. The state says that change, along with utilization management and anti-fraud work, has slowed ABA growth to under 10% a year. The governor's office now projects ABA spending for fiscal 2026-27 at about $2.88 billion, compared with an earlier projection of $3.86 billion, a reduction of nearly $1 billion.

Those figures are projections of lower spending, not dollars recovered from fraudsters, and the state attributes the reduction to several factors at once.

New identity screening with SentiLink

AHCA is also running a pilot with identity verification company SentiLink, which screens provider applications for stolen identities, synthetic identities and hidden ownership structures before a provider can enroll or bill. Harris said the tool has flagged hundreds of providers, WJXT reported.

The pilot was announced in June alongside the broader initiative, which also added data analytics, claims monitoring and expanded background screening. The state's stated goal is to stop improper payments before they go out rather than trying to recover money after the fact.

Federal pressure from CMS and Dr. Oz

Florida's crackdown has unfolded under scrutiny from Washington. In March, Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz sent letters to Florida, California, Maine and New York questioning oversight of their Medicaid programs. Oz wrote on social media that Florida "has been a hotspot for health care fraud for years" and gave state officials 30 days to answer detailed questions about program oversight.

In April, Oz followed with directives to every governor and state Medicaid director to accelerate revalidation of Medicaid providers. DeSantis announced Florida's Medicaid integrity initiative on June 12, also in West Palm Beach. It requires every active Florida Medicaid provider to revalidate its credentials and identity, and providers who do not comply or do not meet program requirements will be removed.

Families and providers raise concerns

The crackdown has not been painless for patients. WPTV has reported on Palm Beach County families whose children's ABA therapy was abruptly cut off, parents who described the therapy as a lifeline that helped their children communicate, manage behavior and function in school. The Florida Phoenix reported that some ABA providers have been dropped from managed care networks since the transition and others have chosen to stop treating Medicaid patients, and ABA providers have told local TV stations that payments have been delayed or denied.

Asked about families struggling to find therapy, DeSantis said the effort targets fraudulent providers, not families. If a provider delivers some legitimate services but mostly fraudulent ones, he said, "to the extent that those services get interrupted, that's not AHCA's fault." Harris said managed care plans have care coordination staff to help families find new providers and urged parents having problems to contact the agency.

A legislatively created ABA task force housed at AHCA is reviewing the program and is due to deliver recommendations by Dec. 31, with a charge that includes preventing disruptions in care for current patients.

What's next

AHCA says it will keep conducting site visits, monitoring claims and referring suspected fraud for investigation, and the statewide provider revalidation will continue. The more than 150 referrals now sit with Attorney General James Uthmeier's office, whose Medicaid Fraud Control Unit decides whether to bring criminal or civil cases. DeSantis tied the effort to the state's broader push to cut spending, pay down debt and fund tax relief, and said additional results will be announced in the coming months.

For Medicaid families, the near-term questions are whether the ABA task force's recommendations change how much therapy children can receive and whether managed care networks have enough providers to absorb patients whose providers were removed or left the program.