Molina Called Its Florida Kids’ Plan Launch “Nearly Flawless.” ABA Providers Report Not Getting Paid

FLORIDA – Molina Healthcare told investors on October 22 that its takeover of Florida’s Children’s Medical Services Plan was “off to a great start.” The next day, CBS Miami reported that ABA providers serving the plan’s children had recently rallied outside Molina’s Doral office, claiming they have not been paid since the switch.

Molina became the plan’s sole statewide operator on October 1, replacing Centene’s Sunshine Health. The plan covers some Florida children with special health care needs through Medicaid and the Children’s Health Insurance Program. Here, CMS stands for Children’s Medical Services, not the federal Centers for Medicare & Medicaid Services. Molina says it took on 115,000 members and puts the contract’s run-rate revenue at about $6 billion a year.

Henry Marines, a South Florida attorney, told CBS Miami the problem is widespread. “I have almost 700 providers that we communicate with, and they all say the same thing. They haven’t been paid,” he said. BreakingNewsABA has not independently verified that count. The CBS Miami report does not say how much money is owed or whether any claims are past a payment deadline.

The report also describes the strain on one technician and one family. Arlene Perez, an RBT (registered behavior technician) who has worked with a 12-year-old boy on the autism spectrum for five years, said she had gone about a month without a paycheck. CBS Miami reported that her agency says most of its claims have gone unprocessed since the switch. “I will until I can’t. There’s gonna be a moment where I have to look for something else to pay my bills,” Perez said.

The boy’s mother, Joyce Jackson, worries the unpaid claims could put his provider out of business. “It’s gonna be hard to meet a new person and get used to that new person,” she said.

What Molina Told Wall Street

Answering an analyst’s question about the Florida contract on the October 22 earnings call, CEO Joseph Zubretsky said Molina was “very encouraged in the first 22 days of the program” and that “the operational and clinical implementation was nearly flawless.” The published transcripts of the call do not show any discussion of the ABA providers’ payment complaints.

CFO Mark Keim projected that medical costs would equal about 99% of the contract’s premium in the fourth quarter. Molina’s 2026 outlook includes a loss of about $1.50 a share tied to launching the contract.

CBS Miami’s October 23 report said Molina had not responded to its requests for comment. Marines told the station he expected Molina to have received state funding for each enrolled child at the start of the month. “They already know beforehand exactly how many recipients or how many members they are gonna receive under the CMS,” he said.

What the State Promised Providers

In an April 28 alert, Florida’s Agency for Health Care Administration (AHCA) told providers that the new plan would pay them promptly and would honor prior authorizations approved before October 1. Children moving from Sunshine can keep their current providers for up to about eight months, into late May 2027, or until their care plan is finalized and ongoing services are authorized, whichever comes first. The alert also said providers outside Molina’s network are to be paid the rate they received before the switch for up to eight months, unless the two sides agree to a different rate.

An AHCA spokesperson told CBS Miami that the agency is “actively investigating payment concerns raised by ABA providers.”

Marines told the station that legal action was likely premature and that he planned to meet with senior Molina executives to seek a resolution.

AT A GLANCE

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