CMS Health Plan Is Moving to Molina: What Florida ABA Agencies and Providers Need to Know

A major change is coming to Florida's Children's Medical Services Health Plan. Beginning October 1, 2026, Molina Healthcare of Florida will take over operation of the CMS Health Plan from Sunshine Health.

For families receiving Applied Behavior Analysis services, ABA agencies, RBTs, BCBAs, and BCaBAs, the transition raises important questions about contracts, authorizations, billing, provider enrollment, and staffing. The CMS Health Plan itself is not disappearing, but the managed care organization responsible for operating the plan is changing.

What is changing with the CMS Health Plan?

Beginning October 1, 2026, Molina Healthcare of Florida will operate the Children's Medical Services Health Plan statewide. Members who currently receive their CMS benefits through Sunshine Health will transition to the CMS Plan operated by Molina.

For ABA providers, this means that working with CMS members may involve a different health plan network, different administrative systems, and Molina's own contracting and provider-management requirements.

One of the most important things for agencies to understand is that an existing Sunshine Health contract does not automatically become a Molina contract. Agencies that plan to continue serving CMS members should review their Molina network status and determine what steps are required to participate.

Will families lose their current ABA services?

The October 1 transition does not mean that existing ABA services are expected to suddenly stop. Continuity-of-care protections are intended to help members continue receiving medically necessary services while providers and families transition to Molina.

Agencies should communicate with families and verify how existing authorizations, appointments, and ongoing treatment plans will be handled during the transition period.

Families should avoid assuming that an existing appointment must be canceled simply because the health plan administrator is changing. Questions about a specific authorization or member should be verified directly with Molina or the appropriate health plan representative.

What ABA agencies need to know

The transition affects more than just the name on an insurance card. ABA agencies may need to update several operational processes as CMS moves from Sunshine Health to Molina.

Agencies should consider reviewing:

• Their Molina contracting and network participation status.
• Provider enrollment and practitioner information.
• Current CMS member authorizations.
• Billing and claims procedures for dates of service before and after October 1.
• Internal payer information and insurance records.
• Staff training related to Molina portals and administrative processes.
• Communication with families currently receiving CMS-funded ABA services.
• Staffing levels for existing and future CMS cases.

Claims may also need to be handled differently depending on when a service was provided. Agencies should carefully review guidance from Sunshine Health, Molina, and the Florida Agency for Health Care Administration when determining where claims should be submitted.

What happened to the Sunshine CMS BA network exception process?

The transition also affects the process Sunshine Health had been using for certain Behavior Analysis practitioners.

Sunshine Health previously maintained a temporary process related to adding certain BA practitioners to contracted groups, including a network-exception process under specific circumstances.

Ahead of the CMS transition, Sunshine announced that new CMS Health Plan Behavior Analysis network exception requests would no longer be reviewed beginning September 4, 2026. Requests received through September 3 could still be reviewed.

This change is specifically connected to CMS moving from Sunshine Health to Molina. It should not be interpreted as meaning that every Florida Medicaid provider enrollment or roster requirement has disappeared.

Agencies moving into Molina's CMS network should follow Molina's own contracting, practitioner enrollment, roster, and provider-management requirements.

What does this mean for RBTs, BCBAs, and BCaBAs?

For individual ABA providers, much of the transition will happen behind the scenes at the agency and insurance level. However, changes in payer networks can also affect staffing needs.

As agencies prepare to serve CMS members through Molina, they may need to confirm that they have enough qualified providers available for their cases.

Agencies may be looking for:

• RBTs available for morning, afternoon, evening, or weekend cases.
• Bilingual providers for families who prefer services in another language.
• BCBAs and BCaBAs available to supervise cases.
• Providers located near specific clients or service areas.
• Providers with school, home, clinic, or community availability.
• Additional staff to support new or transitioning CMS cases.

Providers should continue verifying employment requirements directly with each agency. Working with a Molina-contracted agency may involve agency-specific onboarding, credential verification, background requirements, supervision requirements, and other administrative steps.

Preparing your ABA agency for October 1

The weeks leading up to the transition are a good time for agencies to review both insurance readiness and staffing readiness.

An agency may be properly contracted and have an approved case, but that case still needs an available provider to deliver services.

Agency owners and clinical leaders can prepare by identifying where they currently have staffing shortages, which ZIP codes are difficult to cover, what schedules remain unfilled, and whether additional supervisors or technicians may be needed.

It may also be helpful to maintain an active recruiting pipeline before a staffing need becomes urgent.

Finding ABA providers through My ABA Case

My ABA Case helps ABA agencies connect with providers who are actively looking for opportunities.

Agencies can post unlimited ABA jobs for free and use the My ABA Case Provider Network to discover RBTs, BCBAs, and BCaBAs who have made their profiles available to agencies.

Through the Provider Network, agencies can:

• Search for providers who are open to work.
• Review provider profiles and experience.
• View availability and location information when provided.
• Find providers for specific service areas and schedules.
• Review resumes when available.
• Contact providers directly through the platform.

For providers, My ABA Case offers another way to find opportunities without relying only on social media groups or manually contacting agencies one by one. Providers can browse ABA jobs, apply to opportunities, and make their profile discoverable so agencies searching for staff can find them.

As Florida ABA agencies prepare for the CMS transition to Molina, insurance contracting is only one part of the process. Having qualified providers available to staff cases remains just as important.

Visit My ABA Case to post ABA jobs for free or explore the Provider Network. Agencies and providers should always verify current contracting, credentialing, authorization, billing, and Medicaid requirements directly with Molina Healthcare, the Florida Agency for Health Care Administration, and other appropriate official sources.