Winter Springs, Florida — State healthcare regulators have removed more than 220 service providers from Florida Medicaid and restricted billing privileges for hundreds more following an expanded enforcement campaign aimed at identifying fraudulent and improper claims, state officials announced.
The enforcement findings, released by the Agency for Health Care Administration, reflect an administrative transition initiated earlier this year away from traditional post-payment recovery toward real-time fraud deterrence before state disbursements occur. Since January, agency investigators have completed over 400 unannounced on-site audits concentrating on sectors demonstrating elevated risk patterns, particularly Applied Behavior Analysis therapy, specialized medical equipment suppliers, and adult day healthcare facilities. Oversight reviews revealed pervasive billing irregularities, including instances where providers submitted reimbursement claims for continuous service periods spanning weekends and holidays, as well as single-day billing entries exceeding 24 hours.
State records show the integrity initiative has resulted in more than 260 medical providers being suspended or subjected to formal reimbursement restrictions. The 220 expelled entities accounted for billing representing in excess of $230 million in Medicaid disbursements during the 2025 calendar year alone, and regulators have forwarded over 150 cases involving suspected criminal deception to the Florida Attorney General's Office for potential prosecution. Furthermore, state officials reported that structural reforms and stricter oversight have reduced projected annual spending on behavioral therapy services by roughly $1 billion, adjusting future allocations down from $3.86 billion to $2.88 billion for the 2026-27 fiscal cycle.
In detailing the agency's enforcement priorities, AHCA Secretary Shevaun L. Harris stressed that strict oversight protects vulnerable populations who depend on state healthcare coverage:
> "Protecting Medicaid means protecting the people it was created to serve. For children, pregnant women, the disabled, and our seniors, it means making sure they have access to high-quality care while ensuring taxpayer dollars are not lost to fraud or abuse." — Shevaun L. Harris, Secretary of the Agency for Health Care Administration
