DeSantis elevates key attorney in Hope Florida Medicaid settlement to judge

Gov. Ron DeSantis on Monday appointed the key attorney behind the controversial Hope Florida Medicaid agreement to serve as a circuit judge in Tallahassee.

Andrew Sheeran, general counsel for the state’s Agency for Health Care Administration since 2023, was the chief legal architect behind the settlement with Medicaid company Centene at the heart of the Hope Florida saga that’s now under a criminal investigation.

Over 22 days in September 2024, Sheeran resurrected a dormant $67 million Medicaid settlement and inserted language to divert $10 million from the total to the Hope Florida Foundation, according to records reported on by the Miami Herald/Tampa Bay Times in August. The foundation was created by the state Legislature in 2023 to support the Hope Florida program — the brainchild of first lady Casey DeSantis to get needy Floridians off government aid by sending them to nonprofits and churches for help instead.

Sheeran inserted language into the Medicaid settlement justifying the $10 million diversion on the grounds that the Hope Florida program would be expanding into Medicaid.

But instead of helping needy Floridians in the Hope Florida program, the foundation quickly gave it away to two groups through separate $5 million grants. Those organizations then gave $8.5 million to a political committee run by DeSantis’ then-chief of staff, James Uthmeier, whom he later appointed as attorney general.

Uthmeier’s political committee, Keep Florida Clean, was intent on defeating the recreational marijuana amendment on the 2024 ballot — a key political priority for DeSantis that election.

The diversion of settlement funds that were ostensibly owed to state and federal taxpayers for political purposes is the subject of a criminal grand jury probe in Tallahassee. Its findings have been kept secret thus far.

Sheeran and the governor’s office did not immediately return requests for comment Tuesday.

Sheeran is replacing Judge John C. Cooper, who retired in December, on the Tallahassee-based Second Judicial Circuit Court, which hears numerous disputes involving state agencies.

He’s the second lawyer linked to the Hope Florida scandal that DeSantis has chosen to be a judge. In January, the governor named former Chief Deputy Attorney General John Guard, who approved the Medicaid settlement, to the Second District Court of Appeal.

Sheeran’s involvement in the Centene settlement

Centene had been trying since 2021 to reach a $67 million settlement with Florida involving allegations of the state overbilling the Medicaid system for prescription drugs.

But progress had stalled until the morning of Sept. 5, 2024, when Sheeran spoke to Centene’s general counsel.

Drafts of the settlement made no mention of the Hope Florida Foundation until six days later, when Sheeran inserted language into the agreement to transfer part of the settlement to the foundation, emails show. Records show the Agency for Health Care Administration had a meeting planned with the governor’s office, run by Uthmeier, a day prior to Sheeran’s draft.

“Per our discussion, see attached redline,” Sheeran wrote to Agency for Health Care Administration Secretary Jason Weida and Chief of Staff Stefan Grow in an email.

Sheeran sent the draft to Guard, the state’s then-chief deputy attorney general, the next day. Guard responded with concerns.

Guard wanted Sheeran to break out how much money the state would pay back to the federal government for its share of the Medicaid settlement. Medicaid, a government-sponsored health insurance program for low-income and needy Floridians, is mostly funded with federal tax dollars.

Sheeran declined to say but made other changes Guard wanted — such as directing the rest of the money, $57 million, to be sent to the Agency for Health Care Administration as opposed to Guard’s office.

“(Agency for Health Care Administration’s) settlement agreements don’t usually detail the federal share, but the Medicaid finance staff are experienced in determining the amount that needs to be returned to (Centers for Medicare and Medicaid Services),” which runs the largely federal health insurance program, Sheeran wrote to Guard.

Current Agency for Health Care Administration Secretary Shevaun Harris told state senators last month that Florida had paid the federal government for the share it was owed from the full $67 million settlement — including the $10 million the state diverted to Hope Florida Foundation, indicating their attorneys believed the federal government could view that $10 million as belonging to the Medicaid program.

“In an abundance of caution, we returned the federal share on that money so that we would avoid any future liability with (the Centers for Medicare and Medicaid Services) or potential litigation,” Harris said.

Money from Medicaid-related legal settlements belongs to state and federal taxpayers, and diverting it to charities or political committees could amount to theft of federal funds or other crimes, former federal prosecutors told the Herald/Times last year. There is no federal probe at this point.

The final settlement agreement signed Sept. 27, 2024, stated that the state health agency “directs” Centene to pay $10 million of the settlement to the Hope Florida Foundation.

That final language was part of an intense negotiation from Sept. 19 to Sept. 27 of that year. Centene wanted the settlement to state that Guard’s office — the state’s top law enforcement entity — was directing the transaction. Guard instead tried to distance the attorney general’s office from the agreement. He argued in emails that the Agency for Health Care Administration was “negotiating this agreement” and directing the payment.

“I think we are down to one real issue,” Centene’s general counsel wrote to Sheeran on Sept. 27.

“I agree that we are down to one issue,” Sheeran responded.

Sheeran and Centene’s lawyer held a phone call later that afternoon, and Centene backed down.

The final version, signed later that day, did not include the additional references to the attorney general directing the $10 million payment from Centene to the foundation. The onus remained with the Agency for Health Care Administration where Sheeran worked.

But it did include a justification for why the transfer of money was appropriate: “(Agency for Health Care Administration) desires an expanded role for Hope Florida in the Medicaid program.”

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