Florida Gov. Ron DeSantis is nearing the end of his state constitutionally-limited time in office, with his second term expiring in January.
But he is leaving behind a legacy of accomplishments that, taken together, is a diagram for conservative policy successes that enhance lives, save taxpayer money, and grow economies.
In June, the Republican governor and former congressman launched a statewide Medicaid Integrity Initiative focused on combating fraud rather than restricting legitimate medical treatment.
Under the initiative, Florida’s Agency for Health Care Administration is partnering with identity-verification firm SentiLink to identify stolen or synthetic identities and concealed ownership structures before providers are approved to participate in Medicaid, rather than uncovering fraud years later through criminal investigations.
The program also requires every active Medicaid provider in Florida to revalidate their credentials or risk removal from the program.
In addition, the state has imposed enrollment moratoriums on certain high-risk provider categories as part of its broader effort to strengthen oversight and reduce fraud within the Medicaid system.
According to the Florida Agency for Health Care Administration, the state has terminated or denied Medicaid enrollment for more than 3,200 providers over the past two years and recovered more than $72 million in improper payments during the last year. State officials say those enforcement actions target fraudulent claims and do not affect reimbursement for legitimate medical services provided to eligible patients.
Supporters of the initiative argue that the rapid growth in Medicaid spending on autism services underscores the need for stronger oversight.
In a June National Review article, Sen. John Kennedy (R-La.) noted that nationwide Medicaid spending on autism therapy increased by 403% between 2019 and 2024.
Kennedy also highlighted Minnesota, where Medicaid spending on autism services reportedly rose from approximately $670,000 to $342.8 million during that period.
Federal prosecutors have charged two clinic operators there with allegedly fraudulently billing $46.6 million for autism therapy services that investigators say were never provided.
Critics say investigators are likely to find more such fraudulent operations.
Separately, an audit by the U.S. Department of Health and Human Services Office of Inspector General found that Maine made at least $45.6 million in improper Medicaid payments for autism services during one review period.
The audit was part of a broader federal examination that identified up to $600 million in potentially questionable Medicaid billing across Indiana, Wisconsin, Maine, and Colorado.
Florida has not faced a major Medicaid fraud indictment involving autism services on the scale seen in some other states, but DeSantis isn’t waiting for one, either
He has said the state is taking preventive steps to strengthen oversight before such problems emerge.
Other states have pursued different approaches to controlling Medicaid costs. According to Axios, Nebraska reduced Medicaid reimbursement rates for Applied Behavior Analysis (ABA) therapy by as much as 80% last year.
Indiana lawmakers have considered payment caps, while New York has weighed similar reimbursement reductions.
Colorado Gov. Jared Polis (D) has also proposed Medicaid budget cuts that families and providers argue could reduce access to services for children with autism.
Supporters of Florida’s Medicaid Integrity Initiative argue that the state’s strategy differs from across-the-board reimbursement cuts because it focuses on identifying fraudulent providers rather than reducing payments for legitimate services.
Critics of reimbursement reductions in states such as Colorado and New York have argued that broad cuts risk affecting both fraudulent operators and providers delivering medically necessary care.
The long-term success of Florida’s Medicaid Integrity Initiative will depend largely on how effectively it distinguishes fraudulent providers from legitimate ones, reports noted.
Families connected to Reflection Services ABA Therapy in Lake Worth have said their children’s Medicaid coverage ended abruptly and that they were not given a clear explanation by the Agency for Health Care Administration.
Those concerns have raised questions about how the state’s enhanced screening process.
How the state handles cases like these may determine whether Florida’s emphasis on fraud prevention is viewed as an effective reform or becomes the subject of broader criticism over its impact on patients and legitimate providers, reports noted.
