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TALLAHASSEE, Florida — Florida’s top Medicaid regulator on Tuesday
sought to explain that a $10 million donation made to a nonprofit
associated with first lady Casey DeSantis’ community-based assistance
program was not made with Medicaid dollars recouped in a much larger
cash settlement.

Amid heightened scrutiny Hope Florida has received over whether it
improperly received money intended for the state, the Florida Agency for
Health Care Administration’s general counsel sought to clarify the
original intent of the money in a Tuesday letter to legislative leaders.

Questions about the program have also led Gov. Ron DeSantis to lash out
at state House leaders throughout most of this year’s legislative
session, accusing them of colluding with Democrats to kill a program
that he has described as a cheaper alternative to publicly subsidized assistance programs that has already helped 30,000 people. And the
battle now has pitted a key House Republican against the state’s
attorney general.

The Centene Corp. and the Florida Agency for Health Care Administration
agreed to a $67 million cash settlement last year over a claim that the
state Medicaid program was charged too much for prescription drugs. The agreement, finalized at the end of September, included a $10 million
donation made by Centene to the nonprofit arm of Hope Florida, a community-based assistance program that subsequently distributed the
grant to groups that campaigned against a recreational pot ballot
measure that failed last year.

The $10 million donation garnered headlines as state lawmakers began
inquiries over the program’s finances. House Health Care Budget Chair
Alex Andrade (R-Pensacola) believes the donation to the Hope Florida
Foundation came from Medicaid dollars that the state had recouped from
Centene.

But AHCA General Counsel Andrew T. Sheeran wrote in his Tuesday letter
to Andrade, House Speaker Daniel Perez (R-Miami) and Senate President
Ben Albritton (R-Wauchula) that the settlement offered by Centene gave
$57 million to cover the Medicaid dollars that were kept by the
company’s former pharmacy benefit manager. Centene also offered up to
$10.8 million for any other alleged damages.

“The law does not prohibit executive branch officials from negotiating settlement conditions that would require a released entity to take
actions other than paying money to the State,” Sheeran wrote in the
letter. “Nor are such provisions unprecedented.”

Andrade is also now focused on Florida Attorney General James Uthmeier,
who he says oversaw the Centene settlement while he was the chief of
staff for Ron DeSantis. While speaking with reporters after a committee
meeting last week, Andrade accused Uthmeier of funneling the $10 million donation from the settlement to political committees that campaigned
against Amendment 3, which sought to permit recreational pot use for
adults but failed to pass in last year’s election.

DeSantis appointed Uthmeier as state attorney general in February. When
asked about the Centene settlement Tuesday, Uthmeier dismissed recent
reporting as “politicized narratives” and — without naming Andrade directly — claimed the state House lawmaker was on a “tirade” and “doing
the bidding of Big Marijuana.” Uthmeier said that he had not been part
of negotiating the deal with Centene to decide where the money went but
that “everything looks legal.” He also defended his work in helping to defeat the amendment that would have legalized marijuana for
recreational reasons for people 21 and up.

“I think the media misunderstands the difference between issue
committees and political candidate committees under the IRS code — an
issue committee can fight against a ballot initiative, and I’m very
thankful those groups stepped up and helped us secure a big win,” he said.

Florida was one of more than 20 states that filed claims against Centene
after they discovered the company’s former PBM failed to pass down the savings from rebates issued by prescription drug manufacturers. The
company had set aside more than $1 billion to settle the claims, leading
to settlements finalized over the past couple of years that included a
$215 million agreement with California and a $165 million to Texas.

Florida was one of the last states to finalize a settlement with
Centene, and it was among a handful that had hired the Jackson, Mississippi-based law firm of Liston and Deas to broker the deal. The
firm told POLITICO in August that it was no longer representing the
state in its settlement and referred questions to the state attorney general’s office. A lawyer from Centene sent a letter to Liston and Deas
in February 2023 urging Florida to consider a $67 million settlement,
which includes up to $10.8 million for “Any other potentially alleged damages.”

AHCA’s Sheeran included the Centene letter in his memo to legislative leaders, which also provided a calculation of the transactions included
in the settlement and other cost factors that led Centene to determine
that the state’s claim involved $57 million in actual Medicaid dollars.

“We are glad to clarify any misunderstanding you may have had and to
confirm that the settlement agreement was and remains consistent with
all applicable laws,” Sheeran wrote.

Andrade’s committee heard testimony last week from Hope Florida
Foundation Chair Joshua Hay, who had said the board had no prior
knowledge of the $10 million donation from Centene until he was briefed
by the board’s lawyer Jeff Aaron. Afterward, Andrade said he planned to invite Aaron to appear during a committee meeting sometime this week and potentially issue subpoenas to obtain records from the nonprofit
foundation, AHCA and the state Department of Children and Families.

Uthmeier added that he was “committed” to complying with public records requests but had not been subpoenaed by the Legislature regarding the investigation.

Kimberly Leonard contributed to this report.

https://www.politico.com/news/2025/04/22/medicaid-hope-florida-donation-00304284

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