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Special Alert: New CMS Plan Clinical Eligibility Process Begins January 11, 2016

Published: January 11th, 2016

Category: Front Page News

Effective Monday, January 11, 2016, a new Florida Department of Health rule will govern how children can be determined clinically eligible for the Children’s Medical Services Medicaid Managed Medical Assistance plan (CMS plan). Under Rule 64C-2.002 of the Florida Administrative Code, treating physicians may attest to a current diagnosis and functional limitation qualifying children with chronic and serious conditions as a referral for enrollment into the CMS plan.

If you are the treating physician of a child and you would like to attest to the eligibility of your patient for the CMS plan, please review the CMS Clinical Eligibility Attestation for Physicians and a list of qualifying chronic and serious conditions. Completed and signed attestations can be submitted by the physician to the Department of Health via secure email at or via fax to (850) 488-3813. Please be sure to submit all five pages of the attestation.

NOTE: Friday, January 8, 2016, is the last day the Agency for Health Care Administration will process requests for enrollment in the Children’s Medical Services plan through the Interim Process to Qualify for Enrollment in the Children’s Medical Services Plan.

If physicians have questions about the CMS Clinical Eligibility Attestation, please contact a CMS plan nurse at (850) 245-4444, extension 3291.

General information about the CMS plan and available services is located at

This message is a Florida Medicaid Health Alert affecting all provider types. For more Florida Medicaid alerts relevant to CMS Plan and Ped-I-Care, please visit