Florida ABA Therapy Providers Say Molina Has Not Paid Them Since Taking Over Children's Medical Services Plan

Applied behavior analysis providers who serve children with autism and other special health care needs across Florida say they have gone weeks without payment since Molina Healthcare took over the state's Children's Medical Services (CMS) Health Plan on Oct. 1, and the Agency for Health Care Administration says it is investigating. A South Florida medical attorney told CBS Miami that he is in contact with almost 700 providers who all report the same problem: they have not been paid since the switch.

The complaints, aired publicly at a recent rally outside Molina's Doral office, are an early test of one of the largest changes in Florida Medicaid this year. The CMS Plan serves children and young adults with serious, chronic medical conditions, and Molina expects it to cover roughly 120,000 enrollees under a contract that runs through 2030.

What providers are reporting

According to CBS Miami's Oct. 23 report, agencies that deliver applied behavior analysis, or ABA, therapy say most of their claims have gone unprocessed since the plan changed hands. ABA is an intensive, often daily therapy widely used for children on the autism spectrum, and much of it is delivered one-on-one by registered behavior technicians in homes, clinics and schools.

One of those technicians, Arlene Perez, told the station she has spent five years working daily with a 12-year-old boy on the autism spectrum and has not received a paycheck in about a month. She said she is continuing to work with him for now, but that at some point she may have to look for other work to cover her bills. "I will until I can't," she told CBS Miami.

Henry Marines, a medical attorney, told the station that Perez's situation is not isolated. He said he communicates with almost 700 providers and that all of them report the same thing. That figure is his estimate. Neither the state nor Molina has released a count of affected providers, unpaid claims or dollars owed, and no total has been reported publicly.

Marines also questioned why a backlog would exist at all. He told CBS Miami that Molina should have received the state's funding for each enrolled child at the start of the month, and that the company knew in advance how many CMS members it would be taking on. Medicaid managed care plans in Florida are paid a set monthly amount per member by the state and in turn pay the providers who deliver care.

What AHCA and Molina say

A spokesperson for the Agency for Health Care Administration, which runs Florida's Medicaid program, confirmed to CBS Miami that the state is looking into the complaints. The spokesperson said the agency is actively investigating payment concerns raised by ABA providers about the Oct. 1 transition of services to Molina.

Molina Healthcare did not respond to CBS Miami's requests for comment. The company has not publicly explained the delays or said when providers can expect payment.

Marines said it is likely too early to pursue legal action over the unpaid claims. He told the station he plans to meet with senior executives at Molina soon to try to reach a resolution.

How the CMS Plan changed hands

For years, the CMS Health Plan was operated by Sunshine State Health Plan, a subsidiary of Centene. As part of its 2025 to 2030 procurement for Statewide Medicaid Managed Care, AHCA chose a new operator. On Nov. 14, 2025, Molina announced that the agency had issued a notice of its intent to award Molina Healthcare of Florida the contract to serve enrollees of the Title XIX (Medicaid) and Title XXI (children's health insurance) portions of the CMS program. Molina said it was the sole plan selected, that it expected to serve about 120,000 enrollees, and that total premiums paid under the program were expected to be about $5 billion in calendar 2025.

The key dates in the handoff, drawn from AHCA, Molina and Sunshine Health materials, are below.

AHCA told families that benefits and covered services would not change and that only the plan's name would. Members moved automatically, with no new application. The agency also said existing appointments, prescriptions and prior authorizations would be honored, and that Molina would accept existing authorizations and process claims accordingly. Providers, the agency said, should continue delivering services as usual.

Under the transition rules, children can keep seeing their current providers during a continuity-of-care period of up to eight months, ending in late May 2027 or when Molina finalizes a new care plan and authorizes ongoing services, whichever comes first. Sunshine told providers that their contracts with Sunshine would not transfer to Molina, so practices that want to keep serving CMS members after that window need to contract and credential with Molina directly. Claims for services delivered before Oct. 1 still go to Sunshine.

Why the switch matters to families

For parents, the worry is less about paperwork than about continuity. Children with autism often depend on routine and on long relationships with the same therapists, and families fear that providers who go unpaid long enough will cut staff or close.

Joyce Jackson, the mother of the boy Perez works with, told CBS Miami she is afraid the unpaid claims could put her son's provider out of business. She said it would be hard for him to get used to someone new. "It's gonna be hard to meet a new person and get used to that new person," she told the station.

A familiar problem for the CMS Plan

This is not the first time a transition at the CMS Plan has been followed by payment trouble. In March 2022, AHCA fined Sunshine State Health Plan $9,092,025 over software problems that delayed payments for nearly three months on tens of thousands of claims for children in Sunshine's Medicaid plan and the CMS Plan, according to reporting by Fresh Take Florida published by WUSF. The state put the number of affected claims at 121,227, far more than the company had previously acknowledged, and calculated the fine at $75 per failed claim.

Sunshine blamed those problems on its Oct. 1, 2021, merger with WellCare of Florida. The state's letter called the problems non-willful, but required the company to show within 30 days that claims were being paid promptly and to give weekly updates to regulators.

That episode showed the state is willing to penalize a CMS Plan operator over claims failures. Whether AHCA takes similar steps with Molina will depend on what its current investigation finds.

What's next

AHCA has not said when its investigation will conclude or what it could lead to. No legislative response has been announced, and the Legislature's 2027 regular session does not begin until March.

For now, providers are waiting on Molina. Marines said he expects to meet with company leadership soon. The outcome will determine whether therapists like Perez keep showing up for the children they serve, or whether families have to start over with new providers in the middle of the school year.