Florida projects Medicaid ABA spending $980 million below earlier forecast

Florida projects $2.88 billion in Medicaid spending on applied behavior analysis (ABA) for fiscal 2026–27, $980 million below an earlier $3.86 billion forecast. The difference is about 25.4% of the earlier projection, not confirmed savings or a reported reduction in actual spending.

Gov. Ron DeSantis’ office announced the projections and state-reported oversight figures on October 6, 2026. It attributed the lower forecast to moving ABA services into managed care, utilization management and efforts to address fraud, waste and abuse. The office did not provide an analysis assigning the forecast difference among those factors.

State reports provider actions and referrals

The Governor’s office said Florida had conducted more than 400 provider site visits since January, focusing in part on ABA, durable medical equipment and adult day care. It also reported more than 150 referrals to the Attorney General’s Office over the prior year based on fraud allegations. A referral is not a criminal conviction.

The state reported that more than 260 providers had been placed under payment restrictions or suspended, and that more than 220 had been terminated from Florida Medicaid for fraud, waste or abuse. These are agency-reported actions; they do not establish that every affected provider committed a crime.

The Governor’s office said terminated providers accounted for more than $230 million in Medicaid billing during 2025. It did not identify that billing as proven losses or recovered funds. The office also cited instances of providers billing for more than 24 hours of services in a day, but did not quantify how widespread those instances were.

In remarks reported by News4JAX, AHCA Secretary Shevaun Harris said Medicaid paid about $6.57 billion for ABA from 2023 through 2025 and had projected 30% year-over-year expenditure growth. The $6.57 billion is a three-year payment total, while the $2.88 billion figure is an annual projection for fiscal 2026–27; they measure different periods.

Managed care and a review of ABA policy

AHCA says managed-care plans began reimbursing for ABA services on February 1, 2025. Services for recipients who are not enrolled in managed care continue through fee-for-service. The Governor’s office described screening, claims monitoring, data analysis, site visits and enforcement as parts of the state’s Medicaid integrity effort.

A separate AHCA advisory body is reviewing how Medicaid delivers ABA services. The 10-seat task force is considering clinical models, care transitions, quality measures, authorization limits, possible duration caps, and provider enrollment and billing standards. Those topics are under review; the task force has not adopted new authorization limits or duration caps. AHCA’s current roster lists one family-member appointment as pending.

The task force must submit recommendations to the Governor, Senate president and House speaker by December 31, 2026. Its authority expires July 1, 2027.

The reported enforcement actions can affect provider participation or payments, but the state has not reported a resulting change in beneficiaries’ access to ABA services or outcomes. Harris said managed-care plans have care-coordination staff to help families find providers and avoid service gaps. AHCA also describes a continuity-of-care period during the managed-care transition, when non-network providers could be reimbursed for ABA services delivered. Those measures are intended to support continuity; they do not establish whether disruptions occurred or were prevented.