Florida Pediatric Group Sues State Over Medicaid Payment Rate Cuts Following ABA Transition

A large pediatric provider organization in Florida is suing the state Medicaid program in an effort to recover primary care funding it alleges was lost after the state revised Medicaid payment rates. The complaint, filed by Pediatric Associates, seeks an order requiring the Florida Agency for Health Care Administration (AHCA) to recalculate the payment rates. The organization serves about 15% of all child Medicaid beneficiaries in the state representing more than 300,000 children, according to the complaint.

On February 1, 2025, AHCA adjusted the rates it pays to contracted Medicaid managed care plans to include the costs of applied . . .