The Waiting Game: Florida’s Budget Standoff and the New Medicaid DMEPOS Pause
I don’t know about you, but every time I check the news coming out of Tallahassee lately, I feel like I’m watching a high-stakes poker game where everyone is bluffing and the pot is just sitting there, untouched. It’s frustrating, right? (Fellow business owner over here nodding in solidarity). One day we think we have a deal on the budget, and the next, everything is back in the air.
As the CMO here at Extra Mile Billing, I spend my days talking to therapy practice owners across Florida. I hear the same thing over and over: “Aaron, when are we going to get some clarity?” Between the budget gap, new enrollment pauses, and bills that seem to vanish into thin air, it’s a lot to keep track of.
I wanted to sit down today and really break down what’s happening. Because let’s be honest, trying to navigate Florida Medicaid regulations can sometimes feel like trying to build a LEGO set without the instructions. I’ve been there, well, not as an owner, but as the guy behind the scenes helping you get paid.
So, let’s look at what’s actually going on with the budget and that new DMEPOS moratorium.
The $1.4 Billion Question
The regular legislative session just wrapped up, and the headline is… well, there is no headline. At least, not a final one. The session ended with a massive $1.4 billion budget gap.
It’s pretty wild to think that our state leaders could walk away without a deal on something that large. But here we are. This gap affects everything from infrastructure to: you guessed it: Medicaid funding. If you’ve been following our podcast, you know we’ve talked a lot about Medicaid rate increases. This budget standoff puts a lot of those hopes on ice for a moment.
I talk to providers who are already operating on razor-thin margins. When the state can’t agree on a budget, it creates this ripple effect of uncertainty. Will the rates stay the same? Will they be cut? It’s enough to make anyone want to pull their hair out.
Mark Your Calendars: April 20th
Since they couldn’t get it done in the regular session, we are heading into a Special Session starting April 20th. This is the “overtime” period. If you’re a practice owner, this is the date you need to watch like a hawk.
This is where the real horse-trading happens. I’m hoping we see some movement on the funding gaps that impact the pediatric therapy world. We’ve seen some great advocacy recently, but it all comes down to what they can agree on in those closed-room sessions.
Sound familiar? It’s that feeling of waiting for a credentialing update that never seems to come. (Phew! The stress is real.)
The New DMEPOS Pause: What You Need to Know
While the budget is grabbing the headlines, something else happened quietly that might impact your practice even more directly. As of March 20, 2026, Florida has implemented a six-month moratorium on new Medicaid DMEPOS supplier enrollments.
For those who aren’t familiar with the acronym soup, DMEPOS stands for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. In the Medicaid world, this is known as Provider Type 90.
I’ve had a few practice owners call me recently, sounding a bit panicked. They were planning to add equipment sales or specialized supplies to their practice to diversify their income. Now? They’ve hit a brick wall.
Why the pause?
The Agency for Health Care Administration (AHCA) followed the federal lead on this. Apparently, they want to strengthen fraud detection and make sure the providers in the system are “high-quality.” I totally get the need to prevent fraud. But for the honest practice owner trying to provide a walker or a specialized brace to a kid in need, this feels like a punch in the gut.
Who does this affect?
The good news (if you can call it that) is that this only applies to new enrollments for Provider Type 90. If you are already enrolled, you’re fine. You can keep billing and providing equipment as usual. Also, if you’re a pharmacy or a hospital where DMEPOS is just a secondary function, you are generally exempt.
But if you were planning to open a new location or start a new entity that focuses on supplies? You’re in a waiting room for at least the next six months.
The PT Bill Disappointment
I’m going to be real with you: this one hurt. We were all pushing for the Physical Therapy Treatment Plan bill (SB 1262/HB 869). This was supposed to streamline how PTs operate and handle treatment plans.
Despite a ton of advocacy from groups like the FPTA, it looks like this bill is getting pushed to next year. I know, I know. It feels like we take one step forward and two steps back sometimes. I’ve seen how much work goes into these advocacy efforts, and it’s a bummer to see it stalled.
However, don’t let this discourage you. Advocacy is a long game. Sometimes you have to plant the seeds for a couple of seasons before you see anything grow. I’ve seen it happen with SLPA supervision rules and other issues. We keep showing up, and eventually, they listen.
A Silver Lining: Telehealth is Here to Stay (For Now)
I didn’t want to leave you with only “wait and see” news. We actually got a win on the federal level that trickles down to us here in Florida. The telehealth flexibilities extension (HR 7148) has been pushed through 2027.
Wait! What? Yep. 2027.
That is a huge relief. I remember at the start of the pandemic, everyone was scrambling to figure out telehealth. Now, for many of our clients, it’s a staple of their practice. It allows you to reach kids in rural areas who otherwise wouldn’t get therapy. Knowing that these flexibilities aren’t going to vanish overnight gives us some much-needed stability.
If you haven’t fully optimized your telehealth billing yet, now is the time. Since we know the rules are staying put for a few years, it’s worth investing in a solid workflow.
How to Navigate the Chaos
I talk to so many owners who feel like they are constantly reacting to the news rather than running their business. It’s exhausting. Every time the rules change, you have to update your processes, talk to your billing team, and cross your fingers that you don’t lose money.
At a high level, here is my advice for the next few months:
- Don’t Panic on DMEPOS: If you were planning to add Type 90 enrollment, just hit the pause button on your side too. Don’t waste money on equipment inventory if you can’t get the Medicaid enrollment processed yet.
- Lean Into Telehealth: Use the stability of the 2027 extension to your advantage. It’s one of the few “sure things” we have right now.
- Stay Informed but Don’t Obsess: You’ve got a practice to run. You can’t spend all day on the AHCA website. (That’s what you have us for!)
- Audit Your Current Billing: With a budget gap, the state might get a little “pickier” with audits and claim denials. I always recommend a quick internal check to make sure your documentation is airtight.
Check out our podcast episode on finding great therapists to help build a team that supports this.
Final Thoughts
This blog has already gone a bit long, but I felt like we needed to cover all these bases. Florida’s healthcare landscape is never boring, I’ll give it that. Whether it’s a cyber attack update or a budget standoff, there’s always something new to navigate.
I realize I’m throwing a lot at you. It’s okay to feel overwhelmed. I’ve been in the billing world for a long time, and even I have to take a deep breath sometimes when a new moratorium drops.
Just remember: you aren’t doing this alone. There is a whole community of therapy practice owners in Florida facing these same hurdles. We are all in this together, trying to make sure the kids get the care they need while we keep our lights on.
Feel free to reach out if you have questions about how the DMEPOS pause specifically affects your current billing setup. We’re here to help you go the extra mile.
You’ve got this!
Aaron and the Extra Mile Team