Virginia Medicaid
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Medallion 3.0


Overview

The Medallion 3.0 program is a fully capitated, risk-based, mandatory managed care program for Medicaid/FAMIS Plus members. Under Medallion 3.0, the Department contracts with managed care organizations (MCOs) for the provision of most Medicaid covered services.

 




Performance Incentives Awards

The Virginia Department of Medical Assistance Services (DMAS) has developed a pay for performance program that will assess MCO performance on measures that DMAS has determined to be instrumental in the goals and objectives of managed care quality improvement for Virginia.

Primary Care Payment Increase for Medicaid Services

As part of the Affordable Care Act, Virginia's Medicaid managed care organizations (MCOs) are required to pay Medicare rates for Medicaid primary care services furnished by eligible physicians in calendar years 2013 and 2014. Eligible physicians are required to attest to their eligibility for the higher payments:

* If you are a DMAS enrolled physician, use the attestation process at the DMAS Portal link below. All attestations of DMAS enrolled physicians will be shared with MCOs.

* If you are not a DMAS enrolled physician, but are enrolled with a Medicaid managed care organization, refer to the instructions on the attestation form located at the link below.


Contacting the Managed Care Office

To contact the Managed Care office by email, please contact ManagedCareHelp@dmas.virginia.gov. Only FAMIS and Medicaid managed care issues should be directed to this email box. For other issues regarding Medicaid, call 804-786-7933.

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