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Department Provides Update on CMS Plan Clinical Eligibility Screening

By Florida Department of Health, Office of Communications

February 12, 2016

Feb. 12, 2016

Department Provides Update on CMS Plan Clinical Eligibility Screening

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

Tallahassee, Fla. - The Florida Department of Health is pleased to report that the revised clinical eligibility screening process for the Children’s Medical Services Managed Care Plan (CMS Plan) is proceeding as planned and running smoothly. It has been one month since the department rolled out the new clinical eligibility screening process for the CMS Plan, which provides a comprehensive system of high quality care for qualifying children in Florida with serious and chronic health care needs.

Since Jan. 11, 2016, more than 6,000 children have been screened using the revised process, which involves a two-part approach to clinical eligibility screening – either a physician attestation, which is an auto-eligibility process using diagnostic codes for chronic and serious conditions, or a parent-based survey. Of the thousands of children screened, 85 percent have been determined to be clinically eligible for enrollment into the CMS Plan. While this percentage represents a preliminary figure after 30 days of screening, a larger data sample will be available at the CMS Plan Rulemaking Workshop to be held in April.

“It is encouraging to see how many children have been screened for eligibility for the CMS Plan this month,” said Chief Operating Officer Jennifer Tschetter. “The department is committed to identifying all eligible children with special health care needs and making clinical eligibility determinations for the CMS Plan as seamless as possible.”

Since Jan. 11, the CMS Plan has received more than 100 attestation forms that physicians have submitted on behalf of their patients. The department is also pleased to report that the response to the new screening process from both families and physicians has been positive.

Parents or guardians of children with special health care needs who want to know if the CMS Plan is right for them should contact their local CMS Office.

To learn more about the CMS Plan, visit http://cmsplan.floridahealth.gov/.

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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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