Three Families Lost Care to a System That Is Not Working

What the Families in Lake Worth Lost

LAKE WORTH, FLORIDA – Three mothers whose children received ABA through Reflection Services ABA Therapy told WPTV in late July that Medicaid would no longer cover the treatment. Talia Quiroz said her daughter Salma, diagnosed at two and a half, has had dangerous regressions since the sessions stopped. “I cannot show, but I have bites all over me,” Quiroz said. Myrian Suarez, who has two sons with autism, described the same. “I have bruised arms from (one of my son’s) pinching,” she said.

Florida had not cut its ABA rates. The Behavior Analysis Fee Schedule effective January 1, 2025 still pays $12.26 per 15-minute unit for the technician code, and the structure has not changed since the state moved to CPT-based billing in August 2022. Florida had not narrowed its coverage policy either. A standing federal injunction from Garrido v. Dudek, decided by the Eleventh Circuit in 2013, requires the state to cover medically necessary ABA for Medicaid-eligible children under 21, which makes a blanket reduction unlawful.

What changed is on the other side of the transaction. Florida is removing ABA providers from its Medicaid program at a scale no other provider category comes close to. When a provider loses the ability to bill, a family experiences it as Medicaid stopping.

893 of 1,403

The number is the state’s own. In its annual report for fiscal year 2024-25, the Agency for Health Care Administration reported denying enrollment or reenrollment to 1,403 providers. Of those, 893 were Provider Type 39, behavior analysis. That is 64 percent of all enrollment denials in a state Medicaid program covering roughly 4 million people. The next-largest category was physicians, at 115.

Secretary Shevaun Harris has also put the multi-year figure on the record. Over the past two years, she said, the agency has terminated or denied enrollment to more than 3,200 providers.

Those denials are not rate policy, and they are not coverage policy. They are decisions about who is permitted to bill, made one provider at a time, and Florida law keeps them confidential while they remain open. That is why a family can lose services with no explanation attached to the loss, and why an agency that asked a general question about cuts can accurately answer that nothing was cut.

Of the 1,403 providers Florida refused to enroll or re-enroll in during one fiscal year, 893 provided behavior analysis. The next-largest category, physicians, accounted for 115.

The Revalidation Announced in West Palm Beach

On June 12, 2026, six weeks before the Lake Worth families spoke to WPTV, Governor Ron DeSantis and Harris announced a statewide provider revalidation. The agency’s own release describes what it commits to: “Conduct a comprehensive statewide provider revalidation effort. All active Florida Medicaid providers will be required to revalidate their credentials and identities. Providers who fail to comply or do not meet program requirements will be removed from the Medicaid program.” Harris told reporters the process would run over the next 12 to 24 months and that providers who do not respond will be disenrolled.

AHCA’s published guidance on revalidation states the consequence precisely: “Failure to complete the revalidation process before your revalidation date will lead to suspension of Medicaid payments and termination of your provider ID resulting in non-payment for services rendered after that date.” Payment stops first. The provider ID is terminated second. Services already delivered go unpaid.

Every ABA provider in Florida is part of that process, and each one now has a date by which its ability to bill turns on paperwork rather than on clinical performance. Lake Worth sits in Palm Beach County, fifteen minutes from the podium where the announcement was made. The families there lost their sessions six weeks later.

The Same Letters in Miami-Dade

The Lake Worth families are not the first in Florida to describe this, and the earlier accounts include details the July story lacked. CBS Miami reported in June that dozens of Miami-Dade County behavior therapy providers approved by the state had lost their contracts with AHCA.

Aliana Gurris, who owns Rainbow Behavior Therapy in Kendall, described the letter that closed her office. “Nothing (in the letter talks about something (being) wrong, about any complaints, nothing,” she said. “Then, that’s it. Finished. Stopped. (They) withheld the payment and that’s it.” Barbara Goodman, an assistant administrator at Awana, said the agency received a 30-day termination notice in May without explanation, having never been audited or cited.

Henry Marines, a lawyer representing four of the terminated agencies, described how the sequence affects a caseload. “They delayed payment of these agencies,” he said, “and these kids were left without services because money was not coming in to pay the technicians.” Payroll is the pressure point. A center that cannot pay technicians cannot maintain a caseload for the weeks it takes to resolve a dispute.

Providers rallied outside AHCA’s Doral office on May 22 and again in West Palm Beach at the end of July. A Spanish-language report by CBS12 on July 28 described the closure of several provider agencies in the Palm Beach area.

The Hiring Pause in Region G

In most of Florida, a family whose provider stops billing Medicaid finds another provider. In Palm Beach County, that has been difficult for 10 months, and the reason is a single-plan notice.

Sunshine Health announced on September 3, 2025, a “temporary pause on adding new practitioners to existing Behavioral Analysis (BA) provider groups,” effective October 1 and not applicable to Regions A and B. On February 20, 2026, the plan said it would resume enrollment starting March 1 in Regions E and F only, and stated that the pause would be lifted “in those regions only.” Palm Beach County is in Region G. No lift has been announced for it.

The pause does not terminate a provider group or end a member’s coverage. What it does is prevent contracted groups in Region G from adding clinicians. Sunshine’s own provider guidance notes that its enrollment process can take up to sixty days and that it will not backdate effective dates.

Put those together, and the arithmetic is unforgiving. A clinic that loses its ability to bill leaves families looking for capacity at other clinics that have been barred from hiring since October, in a plan network where onboarding a new clinician takes two months, and no claims are paid for the gap.

What AHCA Has Said

The agency has answered this question, though not for the Lake Worth story. Asked by CBS Miami in June about the Miami-Dade terminations, AHCA said there had been no reduction in funding for behavior analysis services. That statement is accurate, and it is also not responsive to what the providers described: which was payment suspension and contract termination rather than a funding cut. In May, the agency told NBC 6 that it was closely monitoring service utilization, provider enrollment, and feedback from families and providers.

Both things are true at once, and that is the whole difficulty for a family trying to understand what happened. Florida’s published rate is intact, its coverage obligation is federally enforced, and its ABA spending has not been reduced. The number that moved is the number of providers permitted to bill it.

The revalidation runs for another 12 to 24 months,s and every ABA provider in the state sits inside it. For an operator in Palm Beach County, the exposure is not the fee schedule. It is the enrollment file, the revalidation date, and a plan network that has been closed to new clinicians since October.

AT A GLANCE

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