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

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CMS Plan Updates and Events

CMS Plan

  • CMS Plan Invitation to Negotiate
  • CMS Plan Service Delivery Model Public Input
  • Payment Delay Due to Hurricane Irma
  • Have You Received a Strange Phone Call?
  • Immigrant Children Now Eligible to Apply for State Health Insurance
  • Final Clinical Eligibility Rule Posted
  • Public Meeting Notice: CMS Plan Service Delivery Model
  • Notice of Correction Posted
  • Notice of Proposed Rule Posted
  • Notice of Accreditation Survey
  • Spring 2016 Member Newsletter
  • Upcoming CMS Plan Rulemaking Workshop
  • Children's Week 2016
  • CMS Resumes Clinical Eligibility Screenings
  • Chief Medical Officer Selected for CMS Managed Care Plan
  • Children's Medical Services (CMS) Plan Technical Advisory Panel

The Department of Health’s Office of the Children’s Medical Service Managed Care Plan is committed to ensuring that all stakeholders are informed on the status of the future CMS service delivery model and making certain that there is transparency throughout this process. The goal in developing a new service delivery model is to provide the best medical care and support for Florida’s children with special health care needs.

This communication is intended to update the public on the development of the new CMS Plan delivery system and advise providers and potential partners that the CMS Plan will issue a competitive procurement in the coming months. Through this procurement, CMS intends to identify a partner or a group of partners to implement an improved model for the CMS Plan to support its continued participation in the Statewide Medicaid Managed Care (SMMC) program

On July 14, 2017, AHCA released an ITN for the SMMC program re-procurement. CMS is continuing with its separate procurement process as outlined in the RFI and public meetings held earlier this year. Prospective partners will be permitted to respond to the future CMS procurement even if they are also responding to the AHCA ITN.

If you are a provider and have questions about your participation status in the CMS Plan provider network, please contact the CMS Plan Provider Relations Liaison in your area.  Note, the AHCA ITN process does not impact your current status as a CMS Plan provider.  We look forward to continuing to work together to improve the health of the children we serve.

Please continue to monitor the CMS Plan website for updates.

Additional Information:

The Department of Health’s Office of the Children’s Medical Service Managed Care Plan (CMS Plan) issued a Request for Information (RFI) for the purpose of planning the development of an improved pediatric health care payment and health service delivery model.  Entities with direct experience in administering and delivering health services to medically complex children with special health care needs (CSHCN) were requested to provide input on the design of a draft model focused on improving the health of children and youth eligible for the CMS Plan. Responses to that RFI were due in May.

In addition, the Florida Department of Health recently held a series of statewide public meetings regarding the CMS Plan service delivery model.  The Department, along with an Agency for Health Care Administration representative, facilitated discussions with CMS Plan families, providers, stakeholders and the general public on improved models for the Titles XIX, XXI or V funded delivery systems for Florida's medically complex children with special health care needs.

A summary report of the input received from CMS Plan families, providers and other interested stakeholders are available on this webpage.

The Florida Department of Health held a series of statewide public meetings regarding the Children's Medical Services Managed Care Plan (CMS Plan) service delivery model. Representatives of the Department provided a brief presentation and facilitated discussions with the CMS Plan families, providers, stakeholders and the general public input intended to inform the evaluation of the feasibility of improved models for the Title XIX, XXI or V funded delivery systems for Florida's medically complex children with special health care needs (CSHCN).


A summary report of the input received from CMS Plan families, providers and other interested stakeholders is now available.

Please be advised that there will be a one day delay in the payment schedule for the week of September 11th due to Hurricane Irma.  Payments that would normally post via EFT on Friday, September 15, 2017 will post on Monday, September 18, 2017. Paper checks will go in the mail one business day later as well. Providers are encouraged to check back for additional updates regarding this matter.

The Florida Department of Health confirmed that CMS Title XXI phone number 866-202-1132 has recently been used in a phone scam.  If you receive a prerecorded message from 866-202-1132 stating "last chance to get a discount on your credit card rate..." or a similar message, please dicountinue the call IMMEDIATELY.  The scammers can alter the appearance of the caller ID to make is seem as if calls regarding fraudulent credit card offers are coming from the CMS Title XXI customer service line at Community Care Plan (866-202-1132).  The offenders may use different ways to obrain or verify someone's personal bank account or for other fraudulent activity.  If you have questions about a call you received, please contact CMS Plan at 850-245-4200.

Effective July 1, 2016, lawfully residing immigrant children in Florida are able to obtain health insurance coverage. Earlier this year, the Florida Legislature eliminated the five-year waiting period for Medicaid and the Children’s Health Insurance Program (CHIP).

If your child was not eligible for health insurance coverage because of the five-year waiting period, you can reapply at any time by contacting the Florida Department of Children and Families (DCF) or Florida KidCare.

For more information regarding the new legislation or to find out if a child is eligible for coverage, please contact DCF by phone (1-866-762-2237) or visit the DCF website at www.MyFLFamilies.com. You can also contact Florida KidCare by phone (1-888-540-5437) or on their website www.FloridaKidCare.org.

The final version of Rule 64C2.002 of the Florida Administrative Code, effective September 27, 2016, is available to view online.

Changes include adding certain codes to the clinical eligibility screening form and adding additional options for physicians to utilize a medical review panel to determine clinical eligibility.  The rule also clarifies that families may request a re-screening to determine clinical eligibility if clinical eligibility was not previously established.

You may also view the following documents:

Clinical Eligibility Screening Rule (64C2.002)
Clinical Eligibility Screening Form (DH-8000)
Physician Attestation Form (DH-8001)
CMS Plan Medical Panel Review Form (DH-8002)

The Florida Department of Health announces a public meeting to which all persons are invited. The public meeting is in regard to the Children’s Medical Services Managed Care Plan (CMS Plan) service delivery model administered by the Florida Department of Health only. Representatives of the Department will facilitate discussions with CMS Plan families, providers and stakeholders and the general public to gather public input intended to inform the evaluation of the feasibility of improved models for Title XIX, XXI or V funded delivery systems for Florida’s medically complex children with special health care needs (CSHCN). The goal is to solicit input from the public related to serving families and children with medically complex, special health care needs.

Three (3) public meetings were held as listed below.  Written comments will also be accepted through 5 p.m. EST on Friday, February 3, 2017.

Wednesday, February 1, 2017, 9 a.m. – 11 a.m.

United Way of Broward—Ansin Building 1300 South Andrews Avenue Ft. Lauderdale, FL 33316

Thursday, February 2, 2017, 9 a.m. – 11 a.m.

Florida Department of Health—Orange County 6101 Lake Ellenor Drive Orlando, FL 32809

Friday, February 3, 2017, 9 a.m. – 11 a.m.

Florida Department of Health—Capital Circle Office Complex 4052 Bal Cypress Way, Room 301 Tallahassee, FL 32399

The CMS Plan is continuing the rulemaking process for rule 64C-2.002 of the Florida Administrative Code. A Notice of Correction for rule 64C-2.002 has been filed and posted online.

Continuing the rulemaking process, the Notice of Proposed Rule for rule 64C2.002 of the Florida Administrative Code has been posted online.

The proposed changes include adding certain codes to the clinical eligibility screening form and adding additional options for physicians to utilize a medical review panel to determine clinical eligibility. The proposed rule also clarifies that families may request a re-screening to determine clinical eligibility if clinical eligibility was not previously established.

You may also view the following documents:

Notice of Proposed Rule
Proposed Clinical Eligibility Screening Form
Proposed Physician Attestation Form
Proposed CMS Plan Medical Panel Review Form

The Accreditation Association for Ambulatory Care, Inc. (AAAHC) will be conducting an accreditation survey of the CMS Plan on August 1-2, 2016.

For more information, please read the Notice of Accreditation Survey.

The Spring 2016 edition of the CMS Plan member newsletter is now available to view online. This newsletter is published quarterly to keep members informed about and connected to the CMS Plan.

In an effort to continue our collaboration with stakeholders and advocates regarding the clinical eligibility screening process, the CMS Plan will host a rulemaking workshop on Wednesday, April 20, 2016. Rules 64C2.002 and 64C2.003 are scheduled for workshop. The rulemaking workshop will focus on reviewing clinical eligibility criteria and redetermination requirements for the CMS Plan.

The Florida Department of Health and the CMS Plan are committed to engaging the public and all interested parties in the rule development process in order to best serve the children in Florida who have special health care needs.

View the rulemaking workshop agenda online

You can also view the following documents related to the rulemaking workshop:

Clinical Eligibility Screening Form

CMS Plan Screening Data from January 11, 2016 through April 10, 2016

Physician Attestation Form Draft

CMS Plan Medical Panel Review Form Draft

Date: Wednesday, April 20

Time: 9:00 a.m. to 5:00 p.m.

Location: Florida Department of Health

4052 Bald Cypress Way, Room 301

Tallahassee, FL 32399

If you require special accommodations to participate in this event, please contact ChildrensMedicalServices@flhealth.gov at least 5 days before the event. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

On Tuesday, January 26, the CMS Plan participated in Children’s Week at the Florida State Capitol. Volunteers and partners worked to create a series of interactive storytelling booths called Storybook Village. The CMS Plan was honored to participate in Storybook Village and share the “Give Me 5 A Day” book with children, families, teachers and other visitors. The book encourages healthy eating habits by reminding kids to eat three vegetables and two fruits every day. As part of the festivities, State Surgeon General and Secretary of Health Dr. John Armstrong read the book aloud with the help of Department of Health employees dressed as fruit and vegetable characters from the book.

“Give Me 5 A Day” was written in collaboration between the department’s Bureau of Child Nutrition Programs and the Bureau of WIC and Nutrition Services. To read an electronic version of the book, visit http://issuu.com/floridahealth/docs/give_me_5_eng-2016?utm_source=article.

The press release for the event can be viewed at http://www.floridahealth.gov/newsroom/2016/01/012616-reads-during-storybook-village.html.

Today, the CMS Managed Care Plan resumed clinical eligibility screening under a new Department of Health rule. Parents may find out if the CMS Plan is right for your child on our Eligibility and Services page. Information for treating physicians is available on our For Health Care Professionals page.

The Florida Department of Health has announced Dr. Mansooreh “Massey” Salari, M.D., as the new Chief Medical Officer for the Children’s Medical Services Managed Care Plan. Dr. Salari has been with the department for over 37 years and has a strong background in pediatric medicine and public health. Visit floridahealth.gov/newsroom to learn more.

The Children's Medical Services (CMS) Plan Technical Advisory Panel met on Oct. 30, 2015 from 8:00am to 10:00am in Tallahassee.