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Children's Medical Services - Special services for children with special needs
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CMS Managed Care Plan

CMS Managed Medical Assistance (MMA)

Notice of Accreditation Survey
The Accreditation Association for Ambulatory Health Care, Inc. (AAAHC) will conduct an accreditation survey of Children’s Medical Services Managed Care Plan (CMS Plan) August 24-26, 2015. The survey will be used to evaluate the organization’s compliance with the AAAHC standards for a health plan and to determine if accreditation should be awarded to CMS Plan. Should you wish to present pertinent and valid information about CMS Plan’s compliance with AAAHC standards, please follow the instructions on the Notice of Accreditation Survey flyer.

The 2011 Florida Legislature created Part IV of Chapter 409, Florida Statutes, to establish the Florida Medicaid program as a statewide, integrated managed care program for all covered services, including long-term care services.

Effective August 1, 2014, Children's Medical Services Network (CMSN) began operating a statewide specialty plan for children with special health care needs under the Managed Medical Assistance component of this new Medicaid program. CMSN partners with two Integrated Care Systems (ICSs) to provide quality health care services to CMSN members. Ped-I-Care serves the central and northern part of the state and South Florida Community Care Network (SFCCN) the southern part.

Claims submission information for CMSN Plan

What Services are covered?

Advanced registered nurse practitioner services Laboratory and imaging services
Ambulatory surgical treatment center services Medical supplies, equipment, prostheses and orthoses
Assistive Care Services Mental health services
Birthing center services Nursing care
Chiropractic services Optical services and supplies
Dental services Optometrist services
Early periodic screening diagnosis and treatment services for recipients under age 21 Palliative care
Emergency services Physical, occupational, respiratory, and speech therapy
Family planning services and supplies (some exception) Physician services, including physician assistant services
Healthy Start Services (some exception) Podiatric services
Hearing services Prescription drugs
Home health agency services Renal dialysis services
Hospice services Respiratory equipment and supplies
Hospital inpatient services Rural health clinic services
Hospital outpatient services Substance abuse treatment services
Immunization services Transportation to access covered services

How does a child qualify?

  • Must be Medicaid eligible
  • Must be under 21
  • Must meet CMS clinical screening requirements

Member Handbook

Member Handbook - Ped-I-Care
Member Handbook - South Florida Community Care Network (SFCCN)

Provider Directories

Below is a map with AHCA regions to assist you in finding the region in which your county resides.

Claim Submission Information

CMSN Pharmacy Prior Authorizations Forms

Cultural Competency Plan (CCP)

Florida Medicaid Preferred Drug List (PDL)

HEDIS performance measures

Managed Medical Assistance (MMA) Title 19 Provider Manual

Please visit this site frequently for updates and additional member and provider information.