The behavioral healthcare and addiction treatment industry in Florida is facing a critical challenge. Addiction treatment providers, who deliver essential care to individuals seeking recovery, are now confronted with a development that threatens the sustainability of their services.
In August 2025, detox and residential treatment facilities throughout Florida contracted with Ambetter, Centene’s ACA Marketplace product, and Sunshine Health, Centene’s Florida Medicaid Managed Care Organization, received notice announcing a significant reduction in reimbursement rates to take effect within 30 days. The new all-inclusive per diem rate, now set at $450, is well below the amount paid by the state for indigent care for the same services and does not reflect the actual costs borne by providers associated with safe, effective treatment.
This rate reduction is not a simple contraction of funding; it is a direct threat to the provision of quality care. Providers are expected to deliver comprehensive services including medically supervised detoxification, individual and group therapy, lab work, 24/7 clinical supervision, and room and board at a rate that falls below the real daily cost of care. Such an all-inclusive payment amount places facilities in an untenable position: operate at a continual loss or compromise the quality and scope of services. This precedent not only destabilizes the current provider landscape but also risks long-term negative outcomes for patient recovery.
These changes arrive on top of an increasingly restrictive regulatory environment. Payors like Ambetter and Sunshine Health have imposed numerous limitations on patient care, including strict controls on hospital stays and heightened administrative requirements, which have already strained the ability of treatment centers to meet patient needs efficiently and effectively.
A further reduction in per diem rates, therefore, is not merely an added difficulty. It represents a substantial barrier to delivering care. As a result, providers may be forced to make difficult decisions, such as reducing staff, limiting services, or, in extreme cases, closing facilities. The broader consequence will be decreased access for Floridians who rely on the ACA or Florida Medicaid for addiction treatment and behavioral health support.
From a legal and operational viewpoint, individual providers hold little sway in negotiations against a large payor such as Centene. By contrast, collective action offers far greater potential for meaningful negotiation. When providers come together as a unified group, they significantly increase their bargaining power. Joint efforts enable resource sharing, the ability to secure expert legal and financial consultation, and the presentation of a compelling, unified message: The new rates are not only unfavorable—they are fundamentally unworkable for the industry and dangerous for patients.
The goal of such collective negotiation is clear: to secure reimbursement rates that accurately reflect the real costs of providing high-quality, evidence-based addiction treatment. This approach is not about demanding excessive compensation, but rather about ensuring the stability and sustainability of services that are critical to individual and community well-being.
The future of addiction treatment in Florida relies on decisive, united action by providers. Now is the time for the industry to stand together, assert its value, and preserve access to life-saving care for those in need.
