Medicaid Monitor
Policy Intelligence
Medicaid Monitor
Policy Intelligence
Updated Fri 12:06 PM MT
© 2026 Lanphier Ventures, LLC
Informational use only. Not legal or compliance advice.
Source
← All Sources

Florida Phoenix

14 stories

Industry·FL·2d ago

Survey Finds Mothers Face Major Barriers to Mental Healthcare Access

Count on Mothers and Inseparable released "Pulse Check 2026: Mothers on Mental Health, Care, and the Systems Around Their Families," a survey of 2,818 U.S. mothers and primary female caregivers conducted May 7-27. The report finds 50% of mothers nationally (48% in Florida) struggled with their own mental health in the past month, and 39% had a child needing behavioral health support in the past year, with 47% of those receiving only partial care or none due to barriers. Among parents facing barriers, 56% reported at least one insurance-related problem. Notably, mothers with employer-sponsored insurance reported less confidence their plans would cover adequate mental health care than mothers covered by Medicaid or CHIP, with only 6% of Medicaid mothers reporting no confidence in coverage versus higher distrust among commercially insured respondents.

Legal·FL·3d ago

Florida House Democrats Ask IRS to Probe Hope Florida Funds

Florida House Democratic Leader Fentrice Driskell and Rep. Kelly Skidmore sent a letter asking the IRS to investigate whether the Hope Florida Foundation and two affiliated nonprofits properly reported, and owe taxes on, $10 million that originated from a Medicaid managed care overbilling settlement. A Leon County grand jury found the funds were misappropriated and routed through two 501(c)(4) organizations to a political committee and ultimately the Republican Party of Florida to oppose a 2024 marijuana legalization ballot measure, though it found insufficient evidence to bring criminal charges. Democrats argue the transfers violated nonprofit political-activity restrictions and are asking the IRS to assess back taxes and penalties. The request follows the August leak of the grand jury's 19-page report and seeks federal accountability after state prosecutors declined to pursue charges.

State Policy·FL·9d ago

Florida ABA Task Force to Hear Managed Care Plans on Autism Therapy Delivery

A Florida task force examining applied behavior analysis service delivery for children with autism and special needs will convene Monday to hear from managed care organization representatives, including Simply Healthcare, Sunshine Health, and Humana Healthy Horizons. The task force is considering potential changes to how the state structures and delivers ABA therapy through its Medicaid program. The meeting follows earlier sessions exploring current delivery models and stakeholder concerns about access and reimbursement.

State Policy·FL·20d ago

Florida Agency Delays KidCare Expansion Despite Legislative Approval

The Florida Agency for Health Care Administration has not provided a timeline for implementing a legislatively approved expansion of KidCare, the state's children's health insurance program for low-income families. Bipartisan state senators questioned agency officials about the delay and ongoing disenrollment issues affecting program eligibility. The expansion was authorized by the Legislature, but the DeSantis administration has not committed to a launch date. The delay affects low-income children's access to coverage through Florida's CHIP program and raises questions about state compliance with federal requirements.

Industry·FL·23d ago

Florida ACA Insurers Propose Premium Increases Up to 39% for 2027

Twelve insurers participating in Florida's ACA marketplace have filed proposed premium increases for 2027, ranging from 3.87% to 39.14%, with AmeriHealth Caritas Florida requesting the highest increase. The Florida Office of Insurance Regulation will review and approve final rates before open enrollment begins November 1, 2026. Florida leads the nation in marketplace enrollment but saw 442,785 residents lose coverage in 2026 after enhanced premium tax credits expired.

State Policy·FL·33d ago

Florida Task Force Reviews $2.7 Billion in Medicaid ABA Services, No Recommendations Yet

A Florida legislative task force met September 1 to review applied behavioral analysis (ABA) services for children with autism and developmental disabilities, examining $2.7 billion in annual Medicaid spending across home, school, office, and community settings. The panel, established by the Legislature in FY 2026-27 budget negotiations, is in information-gathering mode and heard presentations on service delivery patterns, including data showing average ABA service duration of 32.5 months and about 10,000 recipients receiving services for five years or more. The task force is charged with recommending revisions to Florida's ABA delivery model to improve care continuity and program sustainability, with final recommendations due to the Legislature by December 31, 2026.

Legal·ID·34d ago

Federal Court Rules Idaho Cannot Bar Abortion When Pregnancy Threatens Patient Health

U.S. District Judge B. Lynn Winmill ruled that Idaho's abortion ban violates the 14th Amendment when a pregnancy threatens a patient's physical or mental health, marking the first post-Dobbs ruling to find a constitutional right to abortion in certain scenarios. Idaho's Attorney General has appealed. The decision could affect health exceptions in the 13 states with near-total abortion bans, five of which (Idaho, Arkansas, Mississippi, Oklahoma, South Dakota) have no health exception. Legal experts suggest this could begin a gradual legal challenge to the scope of Dobbs, potentially reaching the Supreme Court.

Legal·FL·37d ago

Florida Judge Allows Pediatric Associates Challenge to Medicaid ABA Rates

An administrative law judge ruled that Pediatric Associates has standing to challenge Florida's Medicaid reimbursement rates for applied behavioral analysis (ABA) services for children with autism. Division of Administrative Hearings Judge W. David Watkins denied the state's motion to dismiss the case on Wednesday. The provider alleges the DeSantis administration miscalculated rates that fail to cover ABA service costs. The ruling allows the rate challenge to proceed to a full hearing on the merits.

State Policy·FL·48d ago

Florida Spent $6.57 Billion on ABA Therapy for Children with Autism, Special Needs in Two Years

Florida spent $6.57 billion on applied behavior analysis (ABA) therapy for children with autism and special needs between 2023 and 2025, more than any other state, according to the state's deputy secretary for Medicaid policy and quality. The spending reflects Florida's Medicaid coverage of ABA therapy for eligible children. The disclosure came during a state briefing but the article does not specify immediate policy changes or effective dates. The expenditure level highlights Florida's significant investment in autism and developmental disability services under Medicaid, which affects health plans administering these benefits and providers delivering ABA services.

Legal·FL·52d ago

Federal Appeals Court Questions Florida Medicaid Redetermination Process in Oral Arguments

A three-judge federal appeals panel questioned Florida officials during oral arguments over the state's Medicaid termination procedures following the end of the COVID-19 public health emergency. The lawsuit, filed three years ago, challenges how Florida conducted eligibility redeterminations and disenrolled beneficiaries after continuous enrollment protections expired. The court's scrutiny focused on the state's procedural compliance with federal notice and due process requirements. The case could affect how states manage Medicaid disenrollment processes and beneficiary protections during eligibility reviews.

State Policy·FL·59d ago

Florida Auditor General Cites Delayed Access to Medicaid Unwinding Records

Florida's Auditor General reported that the Department of Children and Families significantly delayed providing records for an audit of Medicaid eligibility redeterminations following the end of the COVID-19 public health emergency. The audit report cites "Significant Audit Constraints" and recommends DCF management demonstrate commitment to accountability, transparency, and compliance with state law. The delay affected the auditor's ability to review how Florida handled the unwinding process that began in 2023. This raises questions about oversight and transparency in Florida's management of Medicaid eligibility operations during a period when millions of beneficiaries nationwide lost coverage.

State Policy·FL·61d ago

Florida Lawmaker Questions Continuing KidCare Continuous Eligibility Legal Fight

A Florida lawmaker is calling for the next governor to reconsider the state's ongoing litigation challenging federal continuous eligibility requirements for children in KidCare, Florida's CHIP program. Governor DeSantis has spent two years in court opposing the federal mandate that children remain enrolled for 12 months. The challenge has prevented implementation of a 2023 state law the governor signed. The legal dispute centers on whether Florida must comply with the federal continuous eligibility policy as a condition of receiving federal Medicaid and CHIP funding.

State Policy·FL·76d ago

Florida Counties Face $420M Medicaid Bill as Property Tax Revenue Declines

Florida's 67 counties will pay nearly $420 million toward state Medicaid spending this fiscal year, according to state economists. Miami-Dade County faces the largest share at $69.4 million, followed by Broward at $34.7 million and Hillsborough County. The county obligation comes as Florida counties anticipate declining property tax revenue. This county-level Medicaid cost-sharing arrangement represents mandatory local government contributions to the state's Medicaid program budget.

Legal·FL·102d ago

Florida Pediatric Provider Sues State Over ABA Rate Methodology in Medicaid Managed Care

Pediatric Associates, Florida's largest Medicaid pediatric provider, filed suit against the DeSantis administration challenging how the state adjusted managed care capitation rates to account for applied behavioral analysis (ABA) services for children with autism and special needs. The lawsuit alleges Florida Medicaid officials improperly calculated rate adjustments when incorporating ABA costs into managed care plan payments. The case directly challenges the state's rate-setting methodology for pediatric behavioral health services delivered through managed care organizations. Litigation outcome could affect how Florida structures capitation payments for high-cost behavioral health services and whether current rates adequately cover provider costs.

Get the daily briefing.