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Cardinal Care Transition

The Virginia Department of Medical Assistance Services (DMAS) is excited to introduce Cardinal Care, a unifying brand encompassing all health coverage programs for Medicaid members. Cardinal Care combines 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 will also include fee-for-service Medicaid members, ensuring smoother transitions for individuals whose health care needs evolve over time.

Given the scope of the program changes, the Virginia Medicaid agency has developed a multi-phase plan to introduce Cardinal Care to its members and providers. Key milestones are:

  • Summer 2022: A single contract will govern Virginia’s unified managed care program, replacing separate contracts for Medallion 4.0 and CCC Plus.
  • January 1, 2023: Official launch of the new Cardinal Care brand, along with a single enrollment website for Medicaid members.

 

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 will continue to provide comprehensive care management for members with significant health needs.

Cardinal Care will simplify provider contracting and credentialing processes during provider enrollment and renewal. 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. Virginia’s six Managed Care Organizations (MCOs) have until January 1, 2023, to establish this streamlined process for 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 six 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.

Additional information will be provided by DMAS and the MCOs. Future updates and next steps will be added to this page over time.

Fee-for-service

No, the blue-and-white Medicaid ID cards will still be valid. Starting January 1, 2023, DMAS will begin to issue new ID cards with the Cardinal Care logo to new Medicaid members. 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. 

Eligibility

DMAS eligibility verification systems will continue to reflect a member’s enrollment in CCC Plus or Medallion through December 31, 2022. On and after January 1, 2023, DMAS eligibility systems will identify a member as having fee-for-service or managed care organization (MCO) enrollment through Cardinal Care. For managed care members, eligibility verifications systems will also include the member’s health plan name and enrollment dates.

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

https://www.anthem.com/

Molina Healthcare of Virginia

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 

https://www.optimahealth.com/providers/

UnitedHealthcare

Medallion: 1-844-284-0146

CCC Plus: 1-877-843-4366

www.uhcprovider.com/

Virginia Premier Health Plan

1-800-727-7536

https://www.virginiapremier.com/providers/medicaid/provider-resources/