Florida officials said Tuesday that enhanced Medicaid oversight efforts have led to lower projected spending in some services and enforcement actions against hundreds of providers.
Gov. Ron DeSantis announced results from the state’s Medicaid Integrity Initiative, which was launched in June and is administered by the Agency for Health Care Administration (AHCA).
The initiative expanded provider screening, claims monitoring, data analysis and site visits while also imposing enrollment moratoriums on certain provider categories and requiring active Medicaid providers to revalidate their credentials. AHCA said it has conducted more than 400 provider site visits since January, with increased attention on Applied Behavior Analysis, durable medical equipment and adult day care providers.
The agency also reported that projected annual Medicaid spending on ABA services declined from $3.86 billion to $2.88 billion for fiscal year 2026-27. The state attributed the change to the transition of ABA services into managed care, utilization management and efforts aimed at identifying fraud, waste and abuse.
AHCA said more than 150 fraud-related referrals were sent to the Attorney General’s Office over the past year. More than 260 providers were placed under payment restrictions or suspended, while more than 220 providers were terminated from the Medicaid program for fraud, waste or abuse.
Those terminated providers accounted for more than $230 million in Medicaid billing in 2025.
AHCA also said it identified billing patterns involving excessive service hours, including some claims totaling more than 24 hours in a single day.