Gov. Ron DeSantis says crackdown on Medicaid fraud saved Florida $230 million

Cindy Krischer Goodman, South Florida Sun Sentinel on Oct 6, 2026

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FORT LAUDERDALE, Fla. — A state-focused crackdown on Medicaid fraud has uncovered “bad actors” and saved Florida as much as $230 million, Gov. Ron DeSantis said Tuesday.

DeSantis said his administration has attacked Medicaid fraud by expanding the state’s use of data analytics, claims monitoring, background screening, site visits, and using other tools to uncover fraudulent billing practices.

“We have put 250 providers on payment restrictions or suspended their payments entirely, and more than 220 providers were terminated from Florida Medicaid for fraud, waste, or abuse, accounting for more than $230 million in billing,” the governor said at a news conference in West Palm Beach. “These actions are focused on bad actors who exploit the program, not legitimate providers delivering necessary care to Floridians.”

Since January, Florida’s Agency for Health Care Administration has conducted more than 400 provider site visits as part of its heightened Medicaid Integrity efforts, DeSantis said. The agency has focused particular attention on areas such as applied behavioral analysis for people with autism, durable medical equipment and adult daycare.

“Some of what the agency has uncovered demonstrates exactly why the heightened oversight is essential,” the governor said. “Providers have billed Medicaid for excessive hours of service, including months of consecutive days of service through every weekend and during every holiday. In some instances, providers have even billed for more than 24 hours of services in a single day.”

Florida’s Medicaid program is one of the largest state health insurance programs in the country, covering roughly 4.3 million residents, according to KFF, a health policy research firm. Medicaid is free or low-cost health coverage for people with limited income. KFF research shows Florida’s total annual Medicaid spending is about $34.6 billion. Florida has not adopted Medicaid expansion, keeping its non-disabled adult income limits among the strictest in the nation.

Unlike other states uncovering fraud where a provider does not exist at all, DeSantis said in Florida some providers offer some services, but also bill for fake services.

“There’s so much more work yet to be done, but today’s announcement should give the public confidence that we’re doing all that we can and making great strides in our war on fraud,” said Shevaun Harris, secretary of the Florida Agency for Health Care Administration. “These fraudsters have sophisticated schemes. It’s forcing us to be nimble and agile and to use every tool at our disposal to combat this issue.”

Harris said the state hired a data analysis/fraud-detection firm called SentiLink to uncover providers with questionable backgrounds and ownership. Medicaid providers must re-enroll every three to five years.

“To date, hundreds of providers have been flagged by this technology, and it’s helping inform our investigative efforts. No longer does it feel like we’re looking for a needle in a haystack,” she said.

Harris said her agency has uncovered providers who take the identifications of real Medicaid recipients and submit false claims.

“The waste and taxpayer dollars is concerning for sure, but what is most concerning is the disservice this does to the families who rely on these providers and those who don’t even know that their Medicaid ID is being misused,” Harris said at Tuesday’s news conference.

Harris appealed to Florida providers to change their behavior. “If you are a provider that’s been placed on payment restrictions, don’t feign ignorance,” she said. “Go back and look at your billing history and patterns. If you made mistakes, fix them and give us back our money.”

She also addressed individuals. “If you’re a recipient or parent of a recipient who is allowing your Medicaid ID or your child’s Medicaid ID number to be used to defraud the state, there’s a separate effort underway to find you too,” Harris said.

DeSantis said AHCA has made more than 150 referrals to the state Attorney General’s Office based on fraud allegations.

The Medicaid fraud crackdown will continue, he said: “This was kind of the opening salvo.”