By Staff Report
A large children’s health care provider is challenging the state agency that oversees Medicaid, alleging it improperly reduced reimbursement rates and jeopardized care for children across Florida.
Pediatric Associates, which says it is the largest children’s health care provider in the state and serves more than 300,000 patients through offices across Florida, filed a challenge Tuesday with the Division of Administrative Hearings. The group alleges the Agency for Health Care Administration incorrectly changed Medicaid reimbursement rates for 2025 and 2026.
If the issue is not corrected for the 2026-2027 fiscal year, the provider says it may be forced to reduce services for Medicaid recipients.
“If the children I care for every day lose access to pediatric care, it would be absolutely devastating,” said Dr. Rasciel Socarras, a Pediatric Associates practitioner based in North Miami, in a statement. “I know from experience that if action is not taken, more families will end up relying on emergency rooms for everyday care — or worse, skipping care entirely.”
The filing cites AHCA’s decision in 2025 to include applied behavioral analysis services in its main pediatric services costs rather than reimbursing those services on a fee-for-service basis.
AHCA then hired a consultant to develop new reimbursement rates that included ABA services. However, the complaint alleges the analysis improperly included newborns and adults in the cost estimates, even though those populations do not use the services. According to the filing, that resulted in lower reimbursement rates for core pediatric care.
“Overall, Florida has experienced a roughly 15% drop in reimbursement for core pediatric care — approximately $15 million per month in cuts to essential funding — even as the cost of providing this care has risen in South Florida’s Regions F through I, where Pediatric Associates’ Medicaid patients are concentrated,” the filing states.
An AHCA spokesperson did not immediately respond Tuesday to a request for comment.
According to the complaint, Pediatric Associates met with AHCA representatives five times between January and May, but the agency has not taken adequate steps to address the issue.
The provider is asking an administrative law judge to review and overturn AHCA’s rate decisions.
According to Pediatric Associates, access to care for children enrolled in Medicaid could be affected if the reimbursement changes remain in place.
“AHCA’s changes … have significantly lowered funding for pediatric care, making it economically infeasible for Pediatric Associates and other similarly situated providers to serve Medicaid patients under this model,” the filing states.
Ali Moreland 
AMBER PATINO