Florida Targets Medicaid Fraud After Providers Billed for More Than 24 Hours a Day
Andrew Powell · Oct 8, 2026 · 2 min read
Florida officials say an aggressive crackdown on Medicaid fraud and improper billing has helped reduce projected annual spending on behavioral therapy services by nearly $1 billion.
According to Fox News, the DeSantis administration said projected spending on Applied Behavior Analysis, or ABA, services is now expected to reach $2.88 billion during fiscal year 2026-27. That is down from an earlier projection of $3.86 billion, a difference of about $980 million.
ABA is commonly used to provide therapy to children with autism. State officials attributed the reduction to a combination of fraud enforcement, managed care and efforts to better monitor how services are being used.
The effort has uncovered some striking billing practices. Florida's Agency for Health Care Administration said investigators found providers submitting claims for services every weekend and holiday for months, including cases where providers billed Medicaid for more than 24 hours of care in a single day.
More than 220 Medicaid providers have been removed from the program for fraud, waste or abuse, according to the governor's office. Another 260-plus providers have faced payment restrictions or suspensions.
State officials also said more than 150 suspected fraud cases have been referred to the Florida attorney general's office over the past year.
“This year, we announced the most significant Medicaid integrity initiative in the history of our state,” Gov. Ron DeSantis said in a news release.
Florida is also expanding its screening process before providers can receive Medicaid payments. Through a pilot program with identity-verification company SentiLink, the state is checking for stolen or fraudulent identities and undisclosed ownership structures.
The state has also established enrollment moratoriums for certain high-risk provider categories. Since January 2026, AHCA said it has issued more than 1,000 adverse decisions involving Medicaid provider enrollment or re-enrollment.
Officials have conducted about 400 provider site visits since January, including inspections involving high-risk areas such as ABA therapy, medical equipment and adult day care.
AHCA Secretary Shevaun Harris said the goal is to make sure Medicaid remains available to people who depend on it while preventing taxpayer money from being diverted through fraudulent claims.
The Florida crackdown comes as Medicaid fraud faces increased scrutiny nationally, including investigations and payment reviews in Minnesota.
Florida officials say their approach is focused on stopping questionable claims before payments are made rather than attempting to recover money after improper payments have already gone out. AHCA said it intends to continue expanding its efforts to identify suspicious providers and billing patterns before they can become costly problems.