Gov. Ron DeSantis's Medicaid integrity drive has cut nearly $1 billion from projected Florida therapy spending after investigators found providers billing more than 24 hours in a single day.

State officials say expanded monitoring of Florida's Medicaid program uncovered suspicious billing in behavioral therapy and other high-risk categories, then blocked the money before it went out the door. Fox News reported that projected annual spending on Applied Behavior Analysis, or ABA therapy often used for autism care, fell from $3.86 billion to an expected $2.88 billion in fiscal year 2026-27, a drop of nearly $980 million tied to enforcement, managed care, and utilization review.

That front-door approach is the point. The DeSantis administration is trying to stop bad claims before taxpayers pay them, instead of chasing stolen dollars after the fact. The same philosophy is now showing up at the federal level as Health and Human Services Secretary Robert F. Kennedy Jr. holds back roughly $1 billion in Medicaid funds from California and Minnesota over fraud concerns.

Providers billed more hours than exist in a day

Florida's Agency for Health Care Administration expanded scrutiny and found providers submitting claims for more than 24 hours of services in a single day. That kind of billing is not a paperwork glitch. It is a flashing warning that the invoice does not match reality.

The enforcement numbers are large. Officials said more than 220 Medicaid providers were terminated for fraud, waste, or abuse. More than 260 faced payment restrictions or suspensions. Over the past year, more than 150 suspected fraud cases went to the Florida attorney general's office.

Since January 2026, the state has logged more than 1,000 adverse decisions on provider enrollment or re-enrollment and completed 400 site visits. Those visits hit high-risk categories including ABA, medical equipment, and adult day care. AHCA also launched a pilot with identity-verification firm SentiLink to screen for stolen or fake identities and hidden ownership structures, and it placed enrollment moratoriums on certain high-risk provider types.

Gov. Ron DeSantis framed the results as a historic integrity push for the state. In a news release, he said:

"This year, we announced the most significant Medicaid integrity initiative in the history of our state, and today, I was proud to announce some of the results from these efforts,"

AHCA Secretary Shevaun Harris, who spoke at an Oct. 6, 2026, news conference in Palm Beach County on the statewide crackdown, put the mission in plain terms. She said:

"Protecting Medicaid means protecting the people it was created to serve,"

Harris added that children, pregnant women, the disabled, and seniors need high-quality care without losing taxpayer dollars to fraud or abuse, and that AHCA will keep holding bad actors accountable. The agency told Fox News Digital that Medicaid fraud is a national problem growing more sophisticated, and that Florida is building a model other states can use: prevent fraud at the front door, verify every provider, and follow the data.

Taxpayers should not have to fund phantom hours while families who follow the rules wait for real care, a pattern also seen when public trust collapses after alleged theft by political insiders.

Kennedy freezes funds to California and Minnesota

Florida's posture matches a broader federal turn away from "pay-and-chase." Kennedy and federal health officials have deferred roughly $867 million in Medicaid payments to California and more than $200 million to Minnesota while they review high-risk claims and demand documentation that the spending was legitimate.

The Washington Examiner reported that the pause followed months of audits and the states' failure to provide requested documentation. The holds are framed as temporary deferrals pending proof, not permanent cuts, but the money stays locked until the paperwork matches the law.

Breitbart reported that reviews flagged excessive in-home care spending in California and high-risk providers in Minnesota. Kennedy stated:

"States that receive federal Medicaid funding must demonstrate that every dollar meets federal requirements. When they cannot, we will not release federal funds until they do."

CMS Administrator Dr. Mehmet Oz was blunt about the old model. He said CMS is done trying to chase stolen and misused funds after they have already left the building. That line is the federal echo of Florida's choice: verify first, pay second.

Democratic governors pushed back hard. California Gov. Gavin Newsom rejected the allegations as "pure politics" and blamed the Trump administration. Minnesota officials cast the hold as retribution. Federal officials answered with the audit trail, not the press conference. When party leaders treat oversight as an attack, voters notice, the same way rising far-left Democrats draw sharper labels ahead of the midterms.

Floodgates, dead beneficiaries, and a 24% spending spike

The New York Post reported Kennedy's charge that prior Democratic leadership "open the floodgates to theft" by dismantling basic program integrity. Kennedy said federal dollars will not go out the door until officials have confidence they are spent lawfully.

California's in-home services spending rose 24% over two fiscal years against a 12% national average, according to that reporting. The review package also included about $221 million in claims tied to people with unsatisfactory immigration status and payments made after death. Those are not abstract "integrity issues." They are concrete ways money leaves the program while lawful residents and patients compete for finite care.

S1 material on Minnesota also noted heightened federal investigations and payment reviews, and teaser reporting said Gov. Tim Walz's approval dropped 31 points after a fraud investigation. The poll details were not fully laid out in the package, but the political cost of weak controls is no mystery when audits and freezes arrive together.

Florida officials say a fraudulent provider stopped at home is a scheme that never migrates to the next state. AHCA has said it welcomes partnership with CMS and other states on that premise. The contrast is clear: one state is terminating enrollers, running site visits, and publishing a nearly billion-dollar spending correction; two large Democratic-led states are answering federal document requests under a funding pause.

National Republicans are already framing the midterms around competence and enforcement, including when Trump vows major gains and draws hard lines against Democratic failures on the trail. Medicaid fraud sits in that lane because every wasted dollar is a dollar not available for children, seniors, and disabled patients who qualify.

Pay-and-chase lost; prevention is the test

For years, the default in too much of public health spending was pay first and investigate later. By then the shell company is gone, the identity is burned, and the recovery rate is a fraction of the loss. DeSantis and AHCA flipped the sequence. Kennedy and CMS are applying the same test to states that cannot document high-risk claims.

That does not require new slogans. It requires enrollment screens, identity checks, site visits, moratoriums on risky categories, and the will to terminate providers who bill hours that do not exist. Florida's projected ABA spend dropping by nearly $980 million is the measurable result of that will.

Democrats who call the freezes pure politics still have a simple way to end them: produce the records that show the claims were lawful. Until then, holding the money is basic stewardship. The same standard should apply when Democrats plan investigative payback if they retake Congress, oversight is not a one-way tool.

Medicaid exists for vulnerable patients, not for operators who invent a 25th hour in the day. Florida showed what happens when a state treats that rule as real. California and Minnesota now face the federal version of the same demand, and taxpayers should expect every state to meet it.