I don’t know about you, but every time I see the words “Special Session” in a news alert, I reach for a second cup of coffee. It’s that time of year again. Tallahassee is heading into overtime.
I was talking to a clinic owner yesterday who felt like the ground was shifting under her feet. Between budget negotiations and new fraud task forces, it’s a lot to track. If you’re feeling a bit of that “policy whiplash,” you aren’t alone. I’ve spent the week digging through the latest updates from the capital so you don’t have to.
Here is the breakdown of what is happening in Florida right now and why your documentation just became your most important asset.
The $52 Billion Handshake
After plenty of back-and-forth, the House and Senate finally struck a deal. We are looking at a $52 billion topline budget in general revenue. Out of that massive pie, $19.2 billion is earmarked for Health and Human Services.
The Special Session officially kicks off tomorrow, May 12, and is scheduled to run through May 29. While the numbers look big, the devil is always in the details. (Fellow business owner, I know you feel that one.)
The main goal of this “overtime” session is to bridge a $1.4 billion budget gap. For those of us in the pediatric therapy world, we are watching the line items very closely. We want to ensure that the services our kids rely on aren’t the ones on the chopping block.
The “ABA Shift” Alarm
I’ve had a few heavy conversations lately regarding what we call the “ABA Shift.” Since early 2025, there has been a noticeable trend of funding moving away from routine pediatric therapy and toward ABA managed care.
This isn’t just a “maybe” anymore: it’s hitting practice runways hard. I’ve seen the impact on cash flow when these shifts happen. If you’ve noticed your reimbursement patterns changing or authorizations getting tighter, this is likely why. It’s a systemic move, and it means we have to be sharper than ever with our billing and coding.
The Fraud Task Force is on the Prowl
Now, for the part that makes everyone a little nervous. The Public Assistance Fraud Task Force (PAFT) is officially on the hunt. This isn’t just a “warning” anymore: they are making moves.
Wait! What? Yep, they recently made a massive $2.8 million SNAP fraud arrest. But it doesn’t stop at SNAP. In Central Florida, there were several Medicaid fraud arrests involving over $70,000 for “fake trips” (non-emergency medical transport).
CMS has officially labeled Florida a “hot spot” for fraud. What does that mean for you? It means we should expect more federal audits and much more oversight. When the feds label an entire state a “hot spot,” they aren’t just looking for the “bad guys.” They are looking at everyone.
Your Best Defense: SPOT Growth
I talk to people all the time who are terrified of audits. (Necessary evil, right?) But I always tell them: the best way to stop worrying about an audit is to act like you’re being audited every single day.
I’m a huge believer in the SPOT Growth framework. If you haven’t heard us talk about it on the podcast, it stands for:
- Systems
- Processes
- Oversight
- Technology
Now is the time to audit your own documentation. Do your notes clearly justify the medical necessity of every single unit billed? Is your oversight process actually catching errors before they go to the payer?
I realized a while back that most “billing errors” aren’t intentional. They are just bad systems. If your technology isn’t talking to your processes, you’re leaving yourself vulnerable to these new task forces.
Don’t Panic, Just Prepare
I know this news can feel heavy. Hearing about “fraud hot spots” and “budget gaps” while you’re trying to treat patients is exhausting. Phew! I get it.
But here is the good news: clean billing is a superpower. When your billing health score is high, you don’t have to stay up at night worrying about Tallahassee or the PAFT. You can focus on what you actually love: helping those kids reach their milestones.
If you’re feeling unsure about where your documentation stands, feel free to reach out. We’ve seen it all, and we’re here to help you navigate these shifts. We can even do a billing assessment to see where you might have gaps.
This news cycle will pass, but the need for solid systems never does. Stay focused, keep your notes tight, and keep doing the great work you’re doing.
You’ve got this!
Aaron and the Extra Mile Team