--- title: "Molina called its $6 billion Florida launch 'nearly flawless'; the state is investigating unpaid claims" description: "Molina Healthcare told investors its $6 billion Florida children's Medicaid contract started cleanly. A day later, the state's health-care agency confirmed it is investigating unpaid claims from the autism-therapy providers serving those children." publisher: "The Inference" section: "Health" published: 2026-11-02T15:50:21.585Z modified: 2026-11-02T15:50:21.585Z canonical: https://theinference.org/article/molina-called-its-6-billion-florida-launch-nearly-flawless-the-state-is-investigating-unpaid-claims language: en keywords: "Molina Healthcare, Medicaid, Florida, Health Insurance" --- # Molina called its $6 billion Florida launch 'nearly flawless'; the state is investigating unpaid claims > Molina Healthcare told investors its $6 billion Florida children's Medicaid contract started cleanly. A day later, the state's health-care agency confirmed it is investigating unpaid claims from the autism-therapy providers serving those children. 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](https://theinference.org/markets/companies/molina-healthcare) 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](https://theinference.org/markets/companies/centene)'s 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](https://www.fool.com/earnings/call-transcripts/2026/10/22/molina-healthcare-moh-q3-2026-earnings-call-transcript/), and the contract [anchors the $4 per share of embedded earnings Molina expects to harvest in 2027](https://theinference.org/article/molina-rallied-on-a-6-billion-contract-it-will-lose-money-on-in-year-one) [2][5]. ## 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](https://www.cbsnews.com/miami/news/aba-providers-unpaid-claims-molina-healthcare-childrens-medical-services-florida/): 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](https://theinference.org/article/molina-healthcare-beat-estimates-and-held-guidance-yet-its-profit-fell-53-and-the-stock-sank-about-5) [4]. Medicaid medical costs absorbed 93.0% of premiums in the quarter, up from 92.0% [4]. *Chart: **Quarterly profit has halved year over year, and nine-month profit is down 82%** Column chart of Molina Healthcare's net income: $79 million in Q3 2025, $38 million in Q3 2026, $632 million in the first nine months of 2025 and $112 million in the first nine months of 2026.* *Net income for the third quarter and the first nine months, year over year. Sources: Molina figures via LineVest (4); the site's October 21 results coverage. [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](https://theinference.org/article/molina-s-10-q-moves-its-two-biggest-medicaid-wins-past-the-2027-recovery-the-street-is-pricing) [2][5]. *Chart: **Molina's Medicaid cost ratio keeps climbing, and Florida is projected at 99%** Column chart of Molina's Medicaid medical cost ratio: 90.5% in Q3 2024, 92.0% in Q3 2025, 93.0% in Q3 2026, and management's projected 99% for the Q4 2026 Florida CMS contract.* *Medicaid medical costs as a share of Medicaid premiums. Q4 2026 is management's projection for the newly launched Florida Children's Medical Services contract, drawn dashed. Sources: Molina 10-Q figures via LineVest (4); Q3 2026 earnings call, CFO Mark Keim (2). [2][4]* ## 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. ## Takeaway The $6 billion Florida children's Medicaid contract anchoring Molina's 2027 recovery is now under a state investigation into unpaid ABA provider claims, and the Q4 print in February is the first test of the projected 99% cost ratio. ## Sources 1. [CBS News Miami, Steve Maugeri, 'South Florida attorney says nearly 700 ABA providers haven't been paid since Molina took over Medicaid claims', 23 October 2026](https://www.cbsnews.com/miami/news/aba-providers-unpaid-claims-molina-healthcare-childrens-medical-services-florida/) 2. [The Motley Fool, 'Molina Healthcare (MOH) Q3 2026 Earnings Call Transcript', 22 October 2026](https://www.fool.com/earnings/call-transcripts/2026/10/22/molina-healthcare-moh-q3-2026-earnings-call-transcript/) 4. [LineVest, 'Molina Healthcare's Medicaid Revenue Growth Could Not Keep Up With Medical Costs', 27 October 2026](https://linevestnews.com/article/2026-10-27-molina-healthcares-medicaid-revenue-growth-could-not-keep-up-with) 5. [Quanteia (The Motley Fool), 'Molina: 3 Key Takeaways for Long-Term Investors', 29 October 2026](https://quanteia.com/news/4b930d05c30161365034a103821ba4cb493c43bfdac9854cd881f606c8b70575) --- Molina called its $6 billion Florida launch 'nearly flawless'; the state is investigating unpaid claims — The Inference. Canonical: https://theinference.org/article/molina-called-its-6-billion-florida-launch-nearly-flawless-the-state-is-investigating-unpaid-claims