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Office of Program Policy Analysis and Government Accountability

Performance Review of Children's Medical Services as Administered by the Children's Medical Services Program Office Within the Department of Health and Rehabilitative Services , Report No. 95-02, July 1995
 
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  • CMS has a long history of providing health services to children with special health care needs and is recognized for providing quality care. It has not developed, however, the systems needed to determine the cost-effectiveness of its services in reaching desired outcomes. Nor has it pursued options to increase Medicaid coverage for its clients and services.
  • Due to changes in Florida's health care environment and Medicaid Program, CMS's historical role in serving children with special health care needs has diminished. For example, in the past, CMS paid for the services provided to its clients. Now, Medicaid is the primary payer for CMS services. Furthermore, Medicaid is in the process of shifting from a fee-for-services system to a managed care system. In the future, private managed-care providers that are willing and able to provide medical and social services to these children are likely to emerge.
  • Two viable options exist for moving the delivery of medical services for children with special health care needs from a state-operated, fee-for-service program to Medicaid HMOs. One option would be to phase out CMS as new providers emerge. The other option would be for CMS to position itself to become a private Medicaid HMO for children with special health care needs. Under either option, the state would need to develop controls to ensure that the children served meet medical and financial eligibility requirements and receive quality care.

Which Government Program Summaries contain related information?

Children's Medical Services

What other OPPAGA-related materials are available?

  • Report No. 04-35 Progress Report: Children’s Medical Services Working to Expand Privatization and Reduce Administrative Inefficiencies, published in May 2004.
  • Report No. 02-04 Special Report: Children’s Medical Services Privatization Is Feasible; Could Save Over $18 Million, But Barriers Must Be Overcome, published in January 2002.
  • Report No. 96-68 Follow-up Report on the Children's Medical Services as Administered by the Department of Health, published in March 1997.

Copies of this report in print or alternate accessible format may be obtained by telephone (850/488-0021), by FAX (850/487-9213), in person, or by mail (OPPAGA Report Production, Claude Pepper Building, Room 312, 111 W. Madison St., Tallahassee, FL 32399-1475).
e-mail address: oppaga@oppaga.fl.gov


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