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Miami Children's Health Plan

Florida's Family Health Plan


Miami Children’s Health Plan now offers access to healthcare for the “whole family.”

Continuity of Care (COC)

Miami Children’s Health Plan (MCHP)is required to ensure continuity of care (COC) during the transition period for Medicaid recipients enrolled in the SMMC program. COC requirements ensure that when enrollees transition from one health plan to another, one service provider to another, or one service delivery system to another (i.e., fee-for-service to managed care), their services continue seamlessly throughout their transition.

MCHP will comply with the below COC provisions:
  • Health care providers should not cancel appointments with current patients. MCHP will honor any ongoing treatment that was authorized prior to the recipient’s enrollment into the plan for up to 60 days after the roll-out date in each region. There must be no disruption of care for enrollees. Care may continue after the transition period with prior authorization.
  • Providers will be paid. Providers should continue providing any services that were previously authorized, regardless of whether the provider is participating in the plan’s network. MCHP will pay for previously authorized services for up to 60 days after the roll-out date in each region and must pay providers at the rate previously received for up to 30 days.
  • Providers will be paid promptly.  During the continuity of care period, MCHP will follow all timely claims payment contractual requirements.  The Agency will monitor complaints to ensure that any issues with delays in payment are resolved.
  • Prescriptions will be honored. MCHP will allow recipients to continue to receive their prescriptions through their current provider, for up to 60 days after the roll-out date in each region, until their prescriptions can be transferred to a provider in the plan’s network.
Region Implementation Date Transition Period End Date

9

12/01/2018

01/31/2019

11

12/01/2018

01/31/2019


The Medicaid Health Plan kids
and families deserve.

Serving enrollees of all ages - not just kids.
Doctors in charge of your whole family's care.
Caring customer service.
Local network of doctors, hospitals and providers in your neighborhood. You don't need to drive to Miami.

Yes.
Miami Children’s Health Plan will now serve
enrollees of all ages - not just children.


At Miami Children’s Health Plan, we care about you. We will work to create a care path for families.
This path includes strong community support, access to health and hope for a better tomorrow.

The same high quality, high touch healthcare you get from Nicklaus Children's Health System will be available to you.
A Medicaid plan focused on you is a mission near and dear to our hearts.

On behalf of our team I invite you to join us.


Miami Children’s Health Plan

Provider Network

Provider Service Network (PSN)

Sponsored by Nicklaus Children's Health System

Sponsored by
Nicklaus Children's Health System

Members of all ages.

Providing services to families
and members of all ages

South Florida is our home

Contact us, we’d like to hear from you.


Join us on this journey - we are “Florida’s Family Health Plan”.