Cardinal Care Transition
The Virginia Department of Medical Assistance Services (DMAS) is transitioning to Cardinal Care, a unifying brand encompassing all health coverage programs for Medicaid members. Cardinal Care will combine Virginia’s two existing managed care programs – Medallion 4.0 and Commonwealth Coordinated Care Plus (CCC Plus) – to create a single identity for all members receiving services through Medicaid health plan partners. The overarching brand and program alignment also includes fee-for-service Medicaid members, ensuring smoother transitions for individuals whose health care needs evolve over time.
The Virginia Medicaid agency launched Cardinal Care on January 1, 2023. The single contract that will govern Virginia's unified managed care program is pending approval by the Centers for Medicare and Medicaid Services (CMS), and is expected to replace the separate contracts for Medallion 4.0 and CCC Plus later in 2023.
You will begin to see the new brand on Medicaid ID cards and MCO ID cards in January. You can also print out this flyer or poster to display in your office that explain the new Medicaid ID cards for members. Here’s what to expect:
Fee-for-service
The blue-and-white Medicaid ID cards will still be valid. Both the old and new cards will enable claims processing. New Cardinal Care Plan First ID cards will clearly reflect the program’s limited benefits coverage.
Managed care
Managed care health plans will revise ID cards to replace Medallion and CCC Plus program names with the Cardinal Care logo. The new cards will be active starting January 1, 2023.
Learn more about Cardinal Care and how it benefits Medicaid providers in this presentation. We encourage you to use these slides to present information about Cardinal Care to provider groups and organizations. You may also learn more about Cardinal Care in this Fact Sheet.
Frequently Asked Questions
Cardinal Care Managed Care covers the full scope of Medicaid managed care covered services, including long-term services and supports within the established screening and coverage criteria. Cardinal Care Managed Care continues to provide comprehensive care management for members with significant health needs.
Cardinal Care will simplify provider contracting and credentialing processes. With the retirement of Medallion 4.0 and CCC Plus, providers will maintain and adhere to only one contract and credentialing process for each of the health plans in which they participate as network providers.
A single, unified managed care program will reduce confusion, simplify the member experience, reduce enrollment churn between managed care and fee-for-service, and improve continuity of care as the member’s needs evolve over time.
Virginia’s newly unified managed care program will continue to partner with the same managed care organizations (MCOs) that currently administer both the Medallion 4.0 and CCC Plus programs. Providers will continue to use the DMAS web-based automated response system (ARS), the Medicall telephonic system, and 270/271 eligibility transactions to verify member eligibility and managed care enrollment.
The DMAS enrollment broker will support the consolidated Cardinal Care Managed Care program. Members will be able to select or change their MCO through a Cardinal Care Managed Care phone number and website.
DMAS and Medicaid MCOs will provide additional information as we phase in this initiative. Check back here regularly for future updates and next steps.
Fee-for-service
No, the blue-and-white Medicaid ID cards will still be valid. Both the old and new cards will enable claims processing. The new cards will include information about claims processing and contact information for members and providers. New Cardinal Care Plan First ID cards will clearly reflect the program’s limited benefits coverage. DMAS will gradually send new cards to all members.
Managed care
MCOs will also revise ID cards to replace Medallion and CCC Plus program names with the Cardinal Care logo. Some MCOs began issuing these new cards to members in late 2022.
If you have questions, please email the Cardinal Care Managed Care contract inbox at ccmccontract@dmas.virginia.gov.
Providers can also contact their managed care health plan for more information. Please find contact information for the plans below:
| Cardinal Care Managed Care Plans Provider Services Contact Information | |
|
MCO |
Phone/Website |
|
Aetna Better Health of Virginia |
1-800-279-1878 https://www.aetnabetterhealth.com/virginia/providers/index.html |
|
Anthem HealthKeepers Plus |
Medallion - 1-800-901-0020 CCC Plus – 1-855-323-4687 |
|
Molina Healthcare |
1-800-424-4518 https://www.molinahealthcare.com/providers/va/medicaid/home.aspx |
|
Optima Health |
Medical - 1-800-229-8822 Behavioral Health – 1-800-648-8420 |
|
UnitedHealthcare |
Medallion: 1-844-284-0146 CCC Plus: 1-877-843-4366 |
|
Virginia Premier Health Plan |
1-800-727-7536 https://www.virginiapremier.com/providers/medicaid/provider-resources/ |
For Members
To find information for members about Cardinal Care, please visit the link below.