Molina called its $6 billion Florida launch 'nearly flawless'; the state is investigating unpaid claims

Arlene Perez, a registered behavior technician, has worked for five years with a 12-year-old boy on the autism spectrum ¹. Since Florida moved his plan to Molina Healthcare▼−0.83% — Molina Healthcare, down 0.83 percent today on October 1, she says she has not received a paycheck ¹. Her agency reports most of its claims unprocessed since the switch, and Perez joined providers rallying outside Molina's Doral office. "I will until I can't. There's gonna be a moment where I have to look for something else to pay my bills," she told CBS Miami ¹.

A $6 billion contract is the recovery plan

The plan is Florida's Children's Medical Services Plan, Medicaid and CHIP coverage for children with special health care needs. Molina became its sole statewide operator on October 1, replacing Centene's▼−4.23% — Centene, down 4.23 percent today Sunshine Health, taking on 115,000 members and about $6 billion a year in run-rate revenue ¹. CEO Joseph Zubretsky gave investors the same figures on October 22↗, and the contract anchors the $4 per share of embedded earnings Molina expects to harvest in 2027 ²⁵.

Flawless on the call, unpaid claims in Doral

Zubretsky called the first 22 days of the program "nearly flawless" ². The next day, CBS Miami reported the payment fight↗: medical attorney Henry Marines, who says he communicates with almost 700 providers, said "they all say the same thing ¹. They haven't been paid" (a count this desk could not verify) ¹. Florida's Agency for Health Care Administration says it is "actively investigating payment concerns raised by ABA providers." Molina has not responded, and the published call transcripts contain no discussion of the complaints ¹.

The margin math has no room for a broken pay run

Quarterly net income fell to $38 million from $79 million a year earlier, and nine-month net income to $112 million from $632 million, which this site covered when the October 21 results landed ⁴. Medicaid medical costs absorbed 93.0% of premiums in the quarter, up from 92.0% ⁴.

CFO Mark Keim projected the Florida contract would run medical costs at about 99% of premium in the fourth quarter, a 5% pre-tax loss on $1.5 billion of revenue, two points of it one-time new-business reserves ². The 2026 outlook books a $1.50-per-share launch loss, and the recovery needs Florida at breakeven or better in 2027 ²⁵.

Molina's defense, and where it thins

Keim told investors days in claims payable stood at 44, consistent with the prior quarter ², and a one-month backlog in a handover of 115,000 complex cases can be transition noise rather than a broken machine. The state's own rules cut the other way: an April alert from AHCA promised providers prompt payment and pre-switch rates honored into late May 2027 ¹.

What settles it before the fourth-quarter print

Watch the AHCA investigation and the meeting Marines plans with Molina's senior executives ¹. The fourth-quarter report, due in February, is the first reading of the 99% projection and of whether providers stay ¹. Florida pays Molina for every enrolled child from day one; the children's therapists are still waiting.