Florida’s ABA Task Force met August 12 under a December 31 deadline. Month caps, record Medicaid spending, and three empty seats shape the review ahead.
Key Takeaways
- The spending figure: Florida Medicaid paid $6.57 billion for applied behavior analysis between 2023 and 2025, roughly four times the next highest state. The Florida ABA Task Force created in this year’s budget has until December 31 to recommend what the state does about it.
- The statutory levers: The authorizing statute directs the panel to examine utilization controls and potential caps on the number of months an enrollee may receive ABA services. Those levers reach provider revenue and family access directly, and they are on the agenda by legislative instruction rather than agency preference.
- Empty seats: Three of the ten seats, all gubernatorial appointments, were vacant at the first meeting, including the seat the statute reserves for a family member of an enrollee receiving ABA. The Chair has proposed completing most recommendations by the end of October.
- Diagnostic pressure: Agency data show roughly one in four Florida children receiving behavior analysis had no autism diagnosis in the encounter records reviewed. Providers should expect that figure to drive tighter diagnostic and documentation standards.
On the morning of August 12, at the Agency for Health Care Administration’s headquarters on Mahan Drive in Tallahassee, a slide went up that explained why the room mattered. Between 2023 and 2025, Florida Medicaid paid $6.57 billion for applied behavior analysis. Indiana, the next state on the list, paid $1.65 billion. North Carolina, third, paid $1.53 billion. California paid $760 million.
Shena Grantham, the agency’s Assistant Deputy Secretary for Medicaid Policy and Quality, told the newly seated Applied Behavior Analysis Task Force that “there’s something unusual happening” in the state’s numbers, according to Florida Phoenix, which covered the meeting. The remark served as a thesis statement for the two hours that followed and, in all likelihood, for the four meetings still to come.
The task force is a creation of the state budget rather than a standalone bill. Section 40 of House Bill 5003-E, passed during the 2026E Legislature, established the ten-member body inside AHCA, required it to convene by August 15, and gave it until December 31 to report to the Governor, the President of the Senate, and the Speaker of the House of Representatives. The panel made that first deadline with three days to spare. Its authority expires July 1, 2027.
What the Florida ABA Task Force Must Deliver by December 31
The statute directs the task force to evaluate six areas: clinical care models tied to appropriate ages, transitions across developmental, educational and community settings, quality metrics, limits and utilization controls on how long services may be authorized, potential caps on the number of months an enrollee may receive services, and ways to enhance provider enrollment and billing standards.
Four of those six touch cost containment directly. The month-cap item is the one providers have watched most closely elsewhere, because it converts a clinical judgment into an administrative ceiling: Indiana paired a multi-year rate phasedown with a 4,000-hour lifetime cap in April. The Legislature also required that the final report include the advantages and disadvantages of each recommendation, which leaves room to describe a lever without endorsing it.
Secretary Shevaun L. Harris, who chairs the body as an ex officio, nonvoting member, suggested at the first meeting that the group finish the bulk of its work by the end of October, while noting the schedule could shift. Five meetings are planned. The second is tentatively set for August 31 at the same Tallahassee address, running four hours rather than two, pairing clinical evidence and care transitions with comparative Medicaid models and managed care.
Florida Medicaid ABA Spending Leads Every Other State
Grantham’s presentation, posted publicly as a meeting document, is the most complete public accounting the agency has offered of the behavior analysis benefit. Florida Medicaid covered 3.89 million people as of June 30 and drew $36.55 billion in the current fiscal year, close to a third of the state’s General Appropriations Act. Against that, behavior analysis served 57,323 recipients under 21, a small population that nonetheless ranks among the program’s ten largest expenditure categories for children. The state comparison the panel was shown draws on federal Transformed Medicaid Statistical Information System data for 2023 through 2025, as cited in the CMS toolkit.
Two figures from the deck will likely shape the rest of the review. The first is diagnostic: across a recent six-month encounter period covering 55,226 recipients, 13,698 (roughly one in four) had no autism spectrum disorder diagnosis identified in the data analyzed. The second is structural: 98.9 percent of recipients receiving behavior analysis are enrolled in a Statewide Medicaid Managed Care plan, meaning authorization, network composition, and payment now run through contracted health plans rather than through the state.
The agency also presented Florida’s age distribution as an outlier. Measured against national encounter data, Florida delivers a smaller share of its services to children five and under and a larger share to children six and older, an inversion of the early intervention model the clinical literature generally favors. It also sharpens a transition problem the field has yet to solve for older children aging toward the end of the benefit.
The state’s history with the benefit is short and steep. The agency’s own timeline begins in 2011 with 52 children receiving services through the iBudget waiver, moves through the 2012 court order that opened coverage, and records 3,600 children by 2014. By 2017, AHCA notes, enrolled providers outnumbered the children being served. A moratorium on new provider enrollment in Miami-Dade and Broward counties followed in 2018.
The Behavior Analysis Fee Schedule the panel reviewed caps reimbursement in fifteen-minute units, running from $5.58 at the largest group configurations to $19.17 at the top of the individual codes. None of this is happening in isolation. On August 4, CMS released a 173-page State Medicaid and CHIP Applied Behavior Analysis Toolkit reporting that national Medicaid and CHIP spending on ABA climbed from roughly $1.94 billion in 2021 to $10.1 billion in 2025, an increase of 421 percent. AHCA has posted the toolkit among the task force’s reference materials.
ABA Access Complaints Meet Three Vacant Task Force Seats
The public comment portion supplied the counterweight. Nicole Grabner, a disabled veteran and the mother of two children with autism, drove more than four hours from Brevard County to tell the panel that families already wait far too long simply to get approved, and to warn that enforcement activity and administrative delay were compounding those waits. She told the panel she had learned during the drive that her youngest son had lost access to his provider. Public comment came fifth on a seven-item agenda in a two-hour meeting. The statute permits the task force to meet by teleconference or other electronic means. The notice and agenda for August 12 listed a Tallahassee address and no remote option.
The agency has been making a different case elsewhere. In a reel on the Florida Agency for Health Care Administration’s Facebook page, carrying the on-screen title “Supporting Families: Strengthening Behavioral Care in Florida,” AHCA tells families that Medicaid continues to cover medically necessary behavior analysis services and that there are more providers available than children needing those services, directing anyone having trouble to their health plan or the Medicaid helpline. The same claim appears in the material Grantham presented to the task force, where it carries close to the opposite meaning. The agency’s program history slide marks 2017 as the year enrolled providers came to outnumber the children being served, listing it beside the arrival of prior authorization and immediately before a 2018 entry recording a spending increase to $500,000,000 a year and the enrollment moratorium imposed in Miami-Dade and Broward counties. A separate slide pairs two charts under the heading “Florida Medicaid BA Provider vs. Recipient,” setting behavior analysis providers as a substantial share of Florida’s entire Medicaid provider base against the children receiving those services, a thin sliver of the state’s Medicaid child population.
That testimony lands against a specific enforcement backdrop. On June 12, Governor Ron DeSantis announced a Medicaid Integrity Initiative that includes a fraud-detection pilot with SentiLink, enrollment moratoriums for high-risk provider categories, and a statewide revalidation requiring every active Medicaid provider to reestablish credentials and identity. The agency’s annual fraud and abuse report for Fiscal Year 2024-25 records more than 1,400 providers blocked from enrolling or reenrolling over documented fraud, 893 of them behavior analysts. The distance between that volume and the documentation failures federal auditors have actually found in state ABA programs is the question providers keep raising, and the closures that follow rarely leave a public record.
The roster rewards a close read. The statute gives the Governor three appointments, the President of the Senate three, and the Speaker three, with the Secretary chairing. All three of the Governor’s seats were unfilled on August 12, including the one reserved for a family member of a managed care enrollee receiving ABA services. The statute requires the Secretary to coordinate with the appointing officers so that the membership adequately represents the specified criteria, and directs that vacancies be filled in the same manner as the original appointment.
Those criteria expressly contemplate managed care representation alongside academic experts, provider community representatives, and physicians. Two of the Speaker’s three appointees come from that category: Kali Wilson, a Registered Nurse who directs the intellectual and developmental disabilities comprehensive managed care program at Florida Community Care, and Carol Gormley, Vice President of Government Affairs at Independent Living Systems, the parent company of Florida Community Care. The President of the Senate appointed Dr. David O. Childers, a developmental-behavioral pediatrician at the University of Florida College of Medicine in Jacksonville; Dr. Kerri P. Peters, Administrative Director of the UF Health Center for Autism and Neurodevelopment; and Stella Johnson, Chief Executive Officer of the Jacksonville nonprofit Hope Haven.
Two appointees lead the Florida Association for Behavior Analysis. Dr. Yanerys León, a Research Associate Professor at the University of Miami and a Speaker appointee, is the association’s 2025-26 President; Peters is its Immediate Past President. In an update posted after the meeting, FABA called the session a productive discussion, said Executive Director Dr. Melissa Olive had given public testimony, and committed to attending all five meetings.
The financing question sits underneath all of it. Florida moved behavior analysis into managed care on February 1, 2025 and adjusted plan rates to absorb the cost. In June, according to Florida Phoenix, Pediatric Associates filed an administrative challenge alleging the agency reduced pediatric reimbursement by nearly $300 million over twenty months to fund that increase, with a final hearing set for October 1 and 2. Elsewhere, states have reached for blunter instruments: New York froze new ABA provider enrollments for six months, halting change-of-ownership processing along with it.
Florida’s $6.57 billion is the number that will travel. The recommendations that reach the Governor’s desk on December 31 will be written in the narrower language of authorization periods, documentation standards, and enrollment rules, and those are the mechanisms that decide whether a provider keeps a contract and a child keeps a schedule. The panel reconvenes on August 31, with the family seat still to be filled.
