Florida had a $67 million settlement, then moved to help charity tied to Casey DeSantis

TALLAHASSEE, Fla. — Before it was fired by Florida in 2023, a politically connected Mississippi law firm negotiated a $67 million settlement with the state’s largest Medicaid managed care plan provider that had overcharged for prescription drugs.

But the final settlement, negotiated in-house by state executives after the law firm was fired, required Centene, the managed care company, to send $57 million to the state and $10 million as a donation to the Hope Florida Foundation.

The deal meant $10 million less for state coffers — but sent a windfall to the now controversial group affiliated with first lady Casey DeSantis and unleashed a political firestorm expected to continue later this week during hearings in the Florida House.

House GOP leaders say the second settlement was a potentially illegal diversion of federal money owed to the people of Florida. State law says any settlement agreement has to go directly to the state coffers, they said.

The law firm that worked on the first settlement, Liston & Deas, said a donation to the foundation wasn’t part of the deal when it entered an agreement with the state’s attorney general in December, 2021, submitted a draft agreement in February, 2022, or when it was fired in March, 2023.

“The first time our firm heard about the settlement between Centene and the State of Florida or the Hope Florida contribution associated with that settlement was on April 8, 2025, when we first saw media reports about these issues,” said Lawrence Deas, a law firm partner, in a statement emailed to the Orlando Sentinel.

The original settlement agreement, first presented by Centene’s lawyers to state officials in February, 2022, just two months after Liston & Deas were hired, called for paying Florida $67 million.

Under state law, Liston & Deas would have been entitled to a contingency fee of nearly $7 million.

That full settlement amount was based on a formula that the law firm and Centene came up with working other similar cases around the country, based each state’s specific number of claims and the money paid out for pharmacy costs in 2017 and 2018.

For Florida that came out to $19.465 million for claims in 2017 and 2018, $36.78 million for the state’s pharmacy outlay those two years, and $10.8 million for “any other potentially alleged damages (contractual or otherwise)” of the covered conduct not already claimed, Christopher Koster, Centene’s general counsel, explained in February 2023 letter to Deas.

Andrew Sheeran, general counsel for the Agency for Health Care Administration, which handled settlement negotiations after the law firm was fired, said in a letter Tuesday to legislative leaders that the section about $10.8 million in the first agreement meant not all the money paid to Florida was federal Medicaid money.

AHCA is the agency responsible for running the state’s Medicaid program for some 4.2 million Floridians.

That means the $10 million given to the Hope Florida Foundation was “neither illegal nor illicit” and did not violate state law, he wrote.

The phrase about the $10.8 million is not in the final settlement agreement the state signed, however.

Gov. Ron DeSantis has called the donation to Hope Florida “the cherry on top” of a very good deal for the state.

But Rep. Alex Andrade, R-Pensacola, and House Speaker Daniel Perez, R-Miami, call it a “creative” but potentially illegal.

The donation has become the center of a controversy surrounding the Hope Florida Foundation, which was seen as a platform for the first lady to enter politics. Hope Florida aims to help get residents off welfare by connecting them to private charities.

Andrade has said all the money from the settlement with Centene was Medicaid money and should have been returned to the state.

Andrade has used the House Health Care Budget Subcommittee, which he chairs, to grill state agency officials and the chairman of the Hope Florida Foundation over the donation and its quick disbursement to two dark-money nonprofits. Those groups than donated millions to a political committee created to raise money to successfully defeat a ballot initiative to legalize marijuana last November.

That political committee was set up by Attorney General James Uthmeier when he was chief of staff for DeSantis, who was eager to see the marijuana proposal defeated at the polls, which it was in November.

Andrade has demanded public records, emails, text messages and call logs from Uthmeier related to the Hope Florida Foundation donation. Andrade also has questions for the foundation’s outside counsel, Jeff Aaron of Orlando.

He wants Uthmeier to testify because he believes Uthmeier orchestrated the transfer of the settlement money from Hope Florida to the group fighting the legalization of marijuana.

Uthmeier has denied wrongdoing. His spokesman Jeremy Redfern said in an email to the Orlando Sentinel that “James wasn’t involved in the 2024 settlement negotiations and had no part dictating the settlement terms.”

Emails reviewed by the Orlando Sentinel that were requested by American Oversight, a nonprofit watchdog organization, show that on at least three occasions in 2002 Uthmeier, as DeSantis’ chief of staff, met with officials from Centene and their legal counsel and lobbyists. The first meeting was held two months after Liston & Deas were hired and negotiations began.

Redfern did not respond to questions about those meetings.

Liston & Deas has been working with states to settle lawsuits with Centene as far back as 2018, when it helped then Attorney General Mike DeWine of Ohio to win a $88 million federal court settlement. They then helped the state of Mississippi win $55.5 million in federal court.

Neither included a side payment or donation to a state-run nonprofit.

Those cases led to Liston & Deas and its other law firm partners to devise a plan with Centene’s cooperation to get more than $1.25 billion in settlements for the 22 states that were overcharged by Centene and its pharmaceutical benefits management company.

As reported by New York Times last March, those attorneys acquired information from Centene and other sources to come up with an agreement template to use with other states. Centene set aside money for the settlements.

The law firm then used its political connections to meet with the attorneys general of other states, working to get them to hire them on a contingency basis to help the states recoup their costs.

Florida was one of those states. After meeting with Liston & Deas, Deputy Chief Attorney General John Guard determined Florida had a potential claim against Centene and decided it was in the state’s best interest to contrast Liston & Deas to help them win back some money. The firm had already done the legwork, investigated the issues and had a proven track record of winning settlements, and he felt no need to bid for proposals from other law firms, Guard said.

During their negotiations with the states, Liston & Deas and Centene came up with a formula using specific information from each state to determine a settlement. Based on that formula, Florida was due $67 million, Centene’s general counsel, Koster said.

“From Centene’s perspective … this proposal is ample to resolve any potential liability to the state,” Koster said.

But state officials now are telling a different story about the settlement negotiations, one that writes Liston & Deas out of the picture.

Centene “proactively made the state aware of a billing issue in 2021 and the state worked for years to ensure it was resolved,” said Bryan Griffin, press secretary for DeSantis, in an email.

Griffin refused to comment on why Liston & Deas was fired.

AHCA took over negotiations from that point forward, Griffin said. The final agreement was signed in September, 18 months after Liston & Deas were fired.

Sheeran, the agency’s attorney, told lawmakers in his letter that “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.”

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