Florida Medicaid Health Care Alert

April 28, 2026

Provider Type(s):ALL

Children’s Medical Services (CMS) Plan Transition

Effective October 1, 2026, the operation of the Children’s Medical Services (CMS) Plan will move from Sunshine State Health Plan, Inc. to Molina Healthcare of Florida, Inc.

Certain children with special health care needs are eligible to enroll in Florida’s Children’s Medical Services Plan (CMS Plan) for enhanced services. Currently, Sunshine State Health Plan, Inc. (Sunshine) operates the CMS Plan contract for both Medicaid (Title XIX) and CHIP (Title XXI) recipients. The Agency recently awarded Molina Healthcare of Florida, Inc. (Molina) the CMS Plan contract statewide. The Agency is working closely with Molina and Sunshine to ensure a seamless transition. After October 1, 2026, recipients and providers wanting to participate in the CMS Plan must enroll with Molina. Molina will be the single plan that offers all services in the CMS Plan.

What does this mean?

Starting on October 1, 2026, Molina will be the only SMMC plan to administer the CMS Plan. Current CMS Plan recipients will be automatically transferred to CMS Plan operated by Molina as part of the transition.

Recipients who do not wish to move to CMS Plan operated by Molina will have the option to choose another plan.

• Title XIX recipients may choose to enroll in another SMMC plan:

Florida Medicaid Choice Counseling: 1-877-711-3662. Staff are available to assist with plan changes Monday-Thursday 8 a.m. - 8 p.m. and Friday 8 a.m. – 7 p.m.

• Title XXI recipients may choose to enroll in another Florida Healthy Kids plan:

Florida KidCare: 1-888-540-KIDS (5437)Staff are available to assist with plan changes Monday through Friday, 8 a.m. - 5 p.m.

Continuity of Care

All recipients initially transitioning from Sunshine to Molina will have a continuity of care (CoC) period of up to eight months. This means recipients may continue seeing their current providers until May 31, 2027, or until their care plan is finalized and ongoing services are authorized, whichever is sooner. Molina is required to reimburse non-participating providers at the rate they received for services rendered to recipients prior to the transition for up to eight months, unless there is an agreement to an alternative rate.

All SMMC plans are required to provide CoC periods for transitioning recipients. Details regarding CoC periods for plans other than Molina can be found on the Agency website at SMMC 3.0_Continuity of Care Provisions.

The Agency has instituted the following CoC provisions:

• Health care providers should not cancel appointments with current patients.
• Providers will be paid promptly by the recipient’s new managed care plan.
• Prescriptions will be honored by the recipient’s new managed care plan.
• Existing prior authorizations approved prior to October 1, 2026, will be honored by the recipient’s new managed care plan.

Providers interested in contracting with Molina can find additional information at Molina_CMS Providers. Molina is contracting with CMS Plan providers now and will prioritize contracting inquiries that promote Continuity of Care. Molina is providing essential information, training sessions, and reference materials for support throughout this transition.

Please visit Molina’s website at Molina_CMS Providers for the most current updates and answers to Frequently Asked Questions.

Additional communications from the Agency regarding this change will be shared at CMS Plan Transition | Florida Agency for Health Care Administration.