Florida Medicaid CMS Plan Changes: What Families and Providers Need to Know About the 2026 Transition

Important changes are coming to Florida’s Medicaid Children’s Medical Services (CMS) Health Plan beginning October 1, 2026.

The Florida Agency for Health Care Administration (AHCA) has announced that Molina Healthcare of Florida will become the new statewide administrator for the CMS Health Plan, replacing Sunshine Health.

While transitions like this can feel overwhelming for families and providers, current information indicates that the goal is to maintain continuity of care and minimize disruptions for children receiving services.

What Is Changing?

Beginning October 1, 2026:

• Molina Healthcare of Florida will operate the CMS Health Plan statewide.
• Sunshine Health will no longer administer the CMS Plan.
• Current CMS Plan members will automatically transition to Molina Healthcare.

Families will not need to submit a new application for coverage during the transition.

What Is Staying the Same?

According to current information released by AHCA and Sunshine Health:

• CMS covered services and core benefits are not changing during the transition.
• Existing appointments, prescriptions, and prior authorizations will continue during the continuity of care period.
• Current CMS Plan members will automatically transfer to Molina Healthcare.
• The CMS Plan name itself will remain the same.

Additional expanded benefits may also become available through Molina Healthcare.

Will My Child Lose Their Current Providers?

This is one of the most common questions families are asking.

Some providers may need to establish contracts directly with Molina Healthcare in order to continue serving CMS Plan members after the continuity of care period ends.

However:

• Existing appointments and authorizations are expected to be honored during the transition period.
• Providers are being encouraged not to cancel appointments.
• Molina Healthcare is actively building its provider network and working to accommodate current providers whenever possible.

Families are encouraged to stay informed and communicate with their providers as additional details become available.

What Is the Continuity of Care Period?

The continuity of care (CoC) period is designed to help reduce disruptions in medical care during the transition.

During this time:

• existing prior authorizations should continue to be honored
• ongoing services should continue without interruption
• families should maintain access to current appointments and care plans

Additional details about the length and structure of the continuity period are expected to be released closer to the transition date.

Do Families Need to Do Anything Right Now?

Families should:

• continue attending appointments as scheduled
• continue receiving services as usual
• monitor communications from Sunshine Health, Molina Healthcare, and AHCA
• verify provider participation as more information becomes available

Transition communications for both families and providers are expected to begin during Summer 2026.

Early School Age

Important Information for Providers

Healthcare providers currently serving CMS Plan members should be aware that:

• provider contracts with Sunshine Health will not automatically transfer to Molina Healthcare
• providers who wish to continue serving CMS members after the continuity period must contract directly with Molina
• Molina Healthcare will provide additional credentialing and contracting information during the transition process

Providers are encouraged to:

• monitor updates from Molina Healthcare and AHCA
• prepare for outreach regarding network participation
• continue serving current patients as usual during the transition

Why This Matters for Pediatric Therapy Services

For families receiving pediatric therapy services such as:

• occupational therapy
• speech therapy
• physical therapy
• feeding therapy

Continuity of care is especially important.

Consistency in therapy services helps support progress, routines, and therapeutic relationships that children depend on for success.

As more information becomes available, families should stay in communication with both their healthcare providers and health plan representatives regarding network participation and authorization updates.

Where to Find Official Updates

Florida Agency for Health Care Administration (AHCA)

https://ahca.myflorida.com

Molina Healthcare Florida – Members

https://www.molinahealthcare.com/members/fl/en-US/pages/home.aspx

Molina Healthcare Florida – Providers

https://www.molinahealthcare.com/providers/fl/medicaid/CMS.aspx

Current CMS Plan Information (Sunshine Health)

https://www.sunshinehealth.com/members/cms.html

Our Commitment to Families

At Progressive Pediatric Therapy, we understand that insurance changes can create uncertainty for families navigating pediatric healthcare services.

Our team will continue monitoring updates related to the CMS Health Plan transition and will work closely with families to help support continuity of care whenever possible.

We encourage families to stay informed, ask questions, and maintain communication with their providers throughout the transition process.