A large children’s healthcare provider is challenging the Florida agency overseeing Medicaid, claiming it incorrectly cut reimbursement rates, jeopardizing care for the children served by the group.<\/p>\n
Pediatric Associates, which says it is the largest children’s healthcare provider in the state serving 300,000 clients with offices throughout Florida, filed a challenge with the Division of Administrative Hearings on Tuesday, alleging the Agency for Health Care Administration incorrectly changed Medicaid reimbursement rates for 2025 and 2026.<\/p>\n
If the issue isn\u2019t corrected for the upcoming 2026-27 rates, Pediatric Associates could have to drop services to Medicaid recipients, the filing states.<\/p>\n
“If the children I care for every day lose access to pediatric care, it would be absolutely devastating,” Dr. Rasciel Socarras, a Pediatric Associates practitioner based in North Miami, said in a statement. \u201cI know from experience that if action is not taken, more families will end up relying on emergency rooms for everyday care \u2014 or worse, skipping care entirely.\u201d<\/p>\n
ALSO READ: Florida reports sharp drop in children’s Medicaid enrollment as KidCare court case nears<\/a><\/p>\n The filing from Pediatric Associates cites the move by AHCA in 2025 to include applied behavioral analysis services in its main pediatric services costs \u2014 instead of a fee-for-service basis \u2014 as the start of the problem.<\/p>\n AHCA then used a consultant to help develop new rates that included applied behavioral analysis services, but the complaint alleges the analysis allowed for newborns and adults to be included in those cost estimates, even though those populations don\u2019t use those services. That led to lower rates for main pediatric services, such as the kind provided by Pediatric Associates.<\/p>\n \u201cOverall, Florida has experienced a roughly 15% drop in reimbursement for core pediatric care \u2014approximately $15 million per month in cuts to essential funding \u2014 even as the cost of providing this care has risen in South Florida\u2019s Regions F through I,<\/a> where Pediatric Associates\u2019 Medicaid patients are concentrated,\u201d the filing states.<\/p>\n