TALLAHASSEE, Florida — A trove of records released by Florida Attorney General James Uthmeier has revealed new details about community-based welfare program Hope Florida and its financial and legal dealings, reviving one of the state’s largest political battles this year between Sunshine State Republicans.
The documents reveal details of a $67 million settlement between Florida and the state’s largest Medicaid provider, meant to settle overbilling claims levied against a now-former pharmacy benefit manager. The final drafts of the settlement included a $10 million donation to the nonprofit arm of Hope Florida, an effort spearheaded by first lady Casey DeSantis, which fell under scrutiny amid rumors about her plans to run for governor. The donation was later used to fund the campaign to defeat a marijuana initiative last year.
The roughly 600 pages of emails and drafts obtained first exclusively by POLITICO provided further detail on that settlement — but they don’t address the larger question of how the $10 million was steered to killing the marijuana initiative effort, known as Amendment 3. And they come as multiple players in the ongoing saga gear up for their own future political plans.
Scrutiny of Hope Florida and the $10 million donation was led by state House Health Care Budget Chair Alex Andrade (R-Pensacola), who grilled state agency chiefs about Hope Florida during meetings he held earlier this year. Gov. Ron DeSantis has fired back at Andrade with questions about his ties to the medical marijuana industry, which footed the bill for Amendment 3.
Hope Florida began under the state Department of Children and Families in 2019 as a program aiming to connect people with local services that would help them become independent of government-subsidized public assistance. Casey DeSantis began promoting Hope Florida a short time after, and the program later spawned the Hope Florida Foundation, to help raise and distribute money without state restrictions. The $10 million donation from the otherwise-unrelated settlement agreement was by far the largest fielded by the foundation, which otherwise struggled to raise funds and manage key financial tasks, such as filing federal taxes.
The $10 million donation was part of a $67 million settlement offered by the state’s largest Medicaid contractor, Centene, and state lawmakers believe the entire amount should have been returned to the Legislature. Instead, a board overseeing the Hope Florida Foundation donated $10 million toward efforts led by Uthmeier to defeat Amendment 3. (Defeating the ballot initiative was a key priority of GOP Gov. Ron DeSantis.)
But the records, some of which were previously confidential under trade secret laws, show the $67 million amount was more than three times the actual loss incurred by the state when it was overbilled.
According to letters sent to the state by Centene, the settlement gave more than $19.4 million to cover the actual loss incurred by the state and another $36.8 million in profits collected by Centene’s former pharmacy benefit manager. There was an additional $10.8 million offered to cover any additional losses or costs associated with the state’s claim. Both sides agreed to cover their own legal costs.
Andrade believes Florida law mandates the entire settlement, including the $10 million donation, be returned to the Legislature. A letter drafted by lawyers from Centene, however, said the entire $67 million settlement was more than three times larger than the state’s actual financial loss.
The Florida settlement stems from an Ohio lawsuit alleging Centene’s former pharmacy benefit manager pocketed tens of millions in drug rebates meant to benefit the state’s Medicaid program. Centene subsequently established a $1.2 billion trust fund to settle similar claims filed by several other states.
“I am hopeful this will help the folks in the governor’s office gain a better understanding of the fact that FL is receiving 3.4 times more than the most aggressive actual damages calculation,” Mississippi lawyer Matthew C. McDonald wrote to Tallahassee lobbyist Crystal Stickle, as detailed in the records. “As we have discussed on multiple occasions, pursuing litigation in FL based on the conduct alleged in Ohio would result in the state recovering far less than is being offered as part of this settlement.”
The records also detail the roles played by several key officials who took part in putting the settlement together. They include emails from Chief Deputy Attorney General John Guard, who is still awaiting Senate confirmation after being nominated by President Donald Trump in late May to become a federal judge. Guard signed off on the finalized settlement in September after he removed the attorney general’s office as the designated recipient of the settlement funds because they involve Medicaid. Guard determined the funds should instead be managed by the state Agency for Health Care Administration, which regulates most of the state’s Medicaid program and is funded by $34.6 billion in federal and state dollars.
Guard, who previously prosecuted cases on behalf of the attorney general’s Medicaid Loss Control Unit, also said the settlement was different from others involving Medicaid funding.
“Normally, the federal share is explicitly detailed in the settlement agreement, and I am not sure AHCA wants us to get the remainder of the money,” Guard wrote in a Sept. 13 email to Andrew Sheeran, the top legal advisor at AHCA. “If it is just going to the Legislature and [general revenue], I can probably make it work, but I believe this is different than I have seen in a settlement with Medicaid monies.”
When Jeremy Redfern, spokesperson for the attorney general’s office, was asked if Guard would offer comment, he said the records spoke for themselves.
Uthmeier, who only met with Centene about the settlement when he was chief of staff for Ron DeSantis, appears to have had minimal involvement based on the records.
Uthmeier was appointed by DeSantis in February to replace former Attorney General Ashley Moody after she was appointed to the Senate. He is now gearing up for a race to keep his position in next year’s elections. Meanwhile, Casey DeSantis has been considering a run for Florida governor and has yet to make a decision.
The controversy and outrage among state lawmakers over Hope Florida’s $10 million donation throughout this year’s legislative session led them to strip funding for the program in this year’s state budget. The state Senate also failed to confirm Children and Families Secretary Taylor Hatch and AHCA Secretary Shevaun Harris due to concerns about the program. But most of the fury died down by the time Ron DeSantis signed this year’s budget at the end of June.
A spokesperson from Uthmeier’s office said the records were able to be released after months of talks with Centene and other lawyers involved with the settlement about releasing drafts of the agreement deemed confidential.
“The documents in question were considered ‘trade secret’ and required consent from Centene to release,” Uthmeier spokesperson Redfern said.
About 60 percent of Florida’s Medicaid budget is covered by federal dollars. McDonald’s letter estimates the overbilling led the state Medicaid program to miss more than $19 million in drug rebates, which is less than one-third of the $67 million offered in the settlement, and only half of the $39 million Andrade told reporters was federal money.
Andrade, the state lawmaker who has led the charge to further investigate Hope Florida, has yet to see the public probes he hoped to spur, though he claims both federal and state officials are investigating the nonprofit arm. In response to a state reporter’s X post on documents related to Hope Florida, Andrade cited a “selective compliance and arbitrary delay in the production of public records” in his own post, also tagging Uthmeier. The state representative has also demanded all of the records provided by Uthmeier’s office to POLITICO.
Andrade said that, even with an inflated settlement amount, the entire sum should have been treated as federal and state Medicaid dollars.
“Any argument to the contrary has come from those trying to cover up the fraud,” Andrade said. “Every legal defendant in the history of litigation has said their settlement offer is more than they believe they owe. This one is no different.”
Andrade had said in April his committee will resume its inquiry of Hope Florida during the legislative session next year. But as of Wednesday, Andrade said he was unsure if state House Speaker Daniel Perez (R-Miami) will make him health care budget chair for another year. He also said AHCA has refused to turn over records he requested several months ago.
“I’m certainly not going to look the other way while James Uthmeier and his office continue to make a mockery of the laws they’re entrusted to enforce,” Andrade said. “Until they produce their public records and act like transparency is important to them again, I obviously have more questions."
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