Some Medicaid enrollees may receive primary and acute care through Medicaid contracted Medallion 3.0 managed care organizations (MCOs). For these Medallion 3.0 MCO enrollees, assessment and evaluation, and outpatient psychiatric and substance abuse therapy services (individual, family, and group) are handled through the individual’s Medallion 3.0 MCO. The community mental health rehabilitative services are carved-out of the Medallion 3.0 MCO contracts and are covered by the BHSA, for Medallion 3.0 MCO enrollees, in accordance with DMAS fee-for-service established coverage criteria and guidelines. The Medallion 3.0s are responsible with providing care coordination to enrollees by assisting with referrals to carved out services and covering transportation for carved-out services. For information about Medallion 3.0 Medicaid MCO coverage, please visit The Medallion 3.0 Webpage.
GAP - Governor’s Access Plan for individuals with serious Mental Illness
The Governor’s Access Plan, to expand healthcare services in Virginia, ended March 31, 2019. GAP was a Medicaid plan that provided limited medical and behavioral health care coverage for low income individuals with Serious Mental Illness (SMI). It included mental health and substance use disorder services, medical doctor visits, medications, access to a 24-hour crisis line, recovery navigation services, and care coordination.