Andrew Powell
Punta Gorda Republican Rep. Vanessa Oliver is backing a measure (HB 1085) to transfer the operation of the Children’s Medical Services (CMS) Managed Care Plan from the Department of Health (DOH) to the Agency for Health Care Administration (AHCA).
The transfer aims to ensure high-quality, family-centered and coordinated health services for children and youth with special care needs. The bill further includes provisions for collaboration between the CMS program and AHCA to establish evaluation measures, while seeking federal approval for certain Medicaid services amendments.
All records and personnel currently involved in the CMS Managed Care Plan under DOH would be transferred to AHCA, along with any unexpended balances of appropriations, pending issues, existing contracts and administrative authority to ensure that ongoing services and agreements remain intact during the transition process.
CMS would be required to conduct clinical eligibility screening for children and youth with special health care needs who are eligible for or enrolled in Medicaid or the Children’s Health Insurance Program.
AHCA would further seek federal approval to amend Florida’s Medicaid Model Waiver for home and community-based services to include children who receive private duty nursing services.
The amended waiver would be required to provide an array of tiered services to more broadly serve medically fragile children who receive these services to ensure that institutional care is avoided so children are able to remain at home.
Services would be required to be provided by health plans participating in the Statewide Medicaid Managed Care program. ACHA would be responsible for implementing the approved waiver subject to available funds, and any limitations provided in the General Appropriations Act, including a limitation on the number of enrollees in the revised waiver.
AHCA would establish specific measures of access, quality, and costs for providing health care services to children and youth with special health care needs. An independent evaluator would be contracted to conduct an evaluation of these services.
The bill would amend and repeal several Florida statutes to conform with the changes, with some being repealed Jan. 1, 2026, while others take effect July 1, 2025. It further states, with the exception of specified dates, the bill would come into effect upon becoming a law.
