Families, educators, and therapy providers rallied Friday to raise concerns about a major shift in how services for children with autism and other developmental conditions are approved in Florida.
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The change—intended to increase oversight and accountability—has sparked backlash from those who say it is putting critical care at risk.
NBC6 heard from parents and providers who say the effects are already being felt at home, in classrooms, and in therapy centers.
Milagros Gil, a teacher, says she is witnessing firsthand the impact on children who were once making steady progress.
“This is the saddest thing I’ve ever seen,” Gil said.
She describes watching students lose skills they had spent years developing.
“You can see the growth since you’re with them for five years. You just start with a nonverbal … and now they’re speaking.”
Gil joined dozens of demonstrators on Friday morning outside the Agency for Healthcare Administration’s offices in Doral. The group gathered alongside the ABA Providers Advocacy Alliance to protest changes they say are preventing children from receiving needed care.
For many parents, the concern is immediate and deeply personal.
“You know what happens when you cut the hours for these kids. They go back. Everything they have accomplished goes back to zero,” said Yolanda Roman, a mother.
Advocates say the changes are reducing access to Applied Behavior Analysis (ABA) therapy—a widely used treatment for children diagnosed with autism spectrum disorder and other developmental conditions.
Cristina De Leon, who attended the rally, said she was there to speak for those who cannot.
“I’m representing the autistic community. I am here to be the voice for the people who don’t have a voice. I’m here to give solutions. We need ABA, we need the services.”
The policy change took effect in February of last year and affects how Medicaid covers ABA therapy for tens of thousands of children across Florida.
The state shifted coverage to private managed care plans, which now control approvals and payments. The move was designed to reduce costs and crack down on fraud within the system.
However, critics argue the approach is too broad and is hurting legitimate providers and families.
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“If they’re so sure that there’s fraud going on, go after the people that you’re sure of. Don’t just shut down everything,” said parent Michelle Roselle.
NBC6 Investigates has previously reported on cases of fraud, including a South Florida woman convicted in 2022 of healthcare fraud after being accused of cheating on a certification exam and billing for services not provided.
But families and providers now say the state’s response is penalizing everyone.
“We need answers—we cannot continue to have our hours and our services taken away,” Roman said.
Families report interruptions or reductions in therapy, fewer available providers, and longer waitlists. Some therapists said they have struggled to become credentialed with insurers, leaving them out of network and unable to treat patients.
“They have taken all their services away,” Roman said, “Why? We don’t know. They just say we don’t accept it anymore for the insurance.”
For mothers like Liliana Sanchez, the impact is felt daily.
She says her two children had their therapy hours cut. “Well, it’s a child out of control.”
In a statement to NBC 6, the Florida Agency for Health Care Administration (AHCA) wrote:
Integrating Behavior Analysis (BA) into Medicaid managed care has represented a significant step toward improving care for children and families across Florida. The managed care model also ensures a commitment to quality with ongoing monitoring and support to maintain high standards of service delivery and positive outcomes for Florida’s children. Florida has implemented and maintained several ongoing strategies to ensure the availability of BA services to Medicaid recipients who need them, including enhanced care coordination, provider network monitoring, and continuity of care provisions.
Enhanced care coordination offered by health plans ensures that BA services are integrated with other needed services to seamlessly access the full array of Medicaid medical and behavioral health supports. All Medicaid health plans are responsible for meeting network adequacy by maintaining enough qualified BA providers to serve their members. The Agency regularly reviews network information submitted by the plans and monitors provider availability to help ensure families continue to have access to needed services in their communities. Finally, Medicaid health plans are responsible for providing continuity of care when their members must transition from one provider to another.
The Agency is closely monitoring service utilization, provider enrollment, and feedback from families and providers. Enhanced health plan reporting and review requirements help ensure that services remain accessible. This concentrated monitoring ensures that children will continue to receive all medically necessary BA services through their health plan.
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This story was originally reported for broadcast by NBC6. AI tools helped convert the story to a digital article, and an NBC6 journalist edited the article for publication
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