Effective February 1, 2019, the Florida Department of Health Children's Medical Services Health Plan has partnered with WellCare of Florida, Inc. (WellCare) to provide managed care services. WellCare is a licensed Florida health plan.
What does this change mean for you and your CMS Health Plan Patients?
This partnership will bring about positive changes that will greatly benefit children and youth with special health care needs and their providers.
- Families of children enrolled in the CMS Health Plan are being notified of this change. We will send each child a new CMS Health Plan member ID card. These ID cards will include new pharmacy and claims processing information.
- Children enrolled in the CMS Health Plan will be offered highly specialized pediatric Care Management. Our CMS Health Plan Care Managers/Care Coordinators will work with you and your CMS Health Plan patients to ensure they receive the care they need, when it is needed.
- Providers serving CMS members will be eligible to earn quality-based financial incentives. We will be introducing P4Q and MPIP for the CMS Health Plan.
- Children enrolled in the CMS Health Plan will have access to an array of expanded benefits, and special programs and services. Together with the DOH, we designed benefits and services that will allow children and families to adhere to their providers' treatment plans and achieve their individual health and quality of life goals.
First, take a look at this Q&A document. It provides answers to some of the most common questions from providers.
For pharmacy information, please visit our CMS Health Plan Pharmacy page.
If you have questions about becoming a network provider, including credentialing, claims, and navigating our systems, please contact your WellCare Provider Relations representative. If you do not know your Provider Relations representative, you may contact FloridaProviderRelations@wellcare.com or call 1-407-551-3200, option 2.
If you are not currently in our network and would like to join, contact Barbara Mason at Barbara.Mason@wellcare.com or 1-407-551-3238.
For all other questions, please call CMS Health Plan Provider Service toll-free at 1-866-799-5321 (TTY 711); Monday - Friday, 8 a.m. to 7 p.m.