Dec. 8, 2015

PROPOSED CMS SCREENING TOOL RULE RECEIVES BALANCED FEEDBACK

Public responds to department's proposal

Contact:
Communications Office
NewsMedia@flhealth.gov
(850) 245-4111

Tallahassee, Fla.—Today, the Florida Department of Health presented and received public comment on the proposed clinical eligibility screening rule for the Children’s Medical Services (CMS) Managed Care Plan. The proposed rule, developed in partnership with the CMS regional medical directors, includes a two-part approach to clinical eligibility screening – a physician-based, auto-eligibility process using diagnostic codes for chronic and serious conditions and a parent-based survey to ensure that all financially eligible children with special health care needs are given the option to enroll in the CMS Plan.

“I appreciate the commitment of today’s participants to moving through the rulemaking process so that we can resume clinical eligibility screenings,” said Chief Operating Officer Jennifer Tschetter. “Today’s dialogue focused on the path forward and I believe everyone came to the table with the best interest of children with special health care needs in mind.”

The next step in the rulemaking process is to file for rule adoption. During the rule hearing, participants also heard from Dr. Jeffrey P. Brosco, professor of clinical pediatrics at the University of Miami and the department’s Title V medical director. He discussed the development and principles of the parent-based survey, as well as, the science behind both proposed clinical eligibility screening pathways.

“As a researcher who follows the national dialogue on this topic, I am pleased to see Florida moving forward with a nationally-recognized, parent-based screening tool to help identify children who may benefit from the CMS Managed Care Plan,” said Dr. Jeffrey P. Brosco.  “There is no perfect way to identify children with serious and chronic conditions. Using assessments from parents about their children gives families a voice and minimizes the burden on them to produce documentation.” 

In partnership with the Agency for Health Care Administration, the department has ensured children with the most severe diagnoses are able to enroll in the CMS Plan during rulemaking. The department remains committed to serving Florida’s children with special health care needs.

Children awaiting clinical eligibility determinations are being served through another Managed Medical Assistance plan with the same level of service agreement as the CMS Plan, or other Medicaid programs. Children currently in the CMS Plan continue to receive the high-quality care and care coordination the CMS Plan provides.

About the Florida Department of Health

The department works to protect, promote and improve the health of all people in Florida through integrated state, county and community efforts.

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