Last month, DMAS shared with you the new Cardinal Care brand that will kick off on January 1, 2023, and will include all health coverage programs for all Virginia Medicaid members. Cardinal Care will combine Virginia’s two existing managed care programs – Medallion 4.0 and Commonwealth Coordinated Care Plus (CCC Plus) – and also will include fee-for-service Medicaid members.

Medicaid members who participate in the managed care programs may have received a new Medicaid identification (ID) card from their health plan. The health plans have started issuing new ID cards this month and will complete the process by March 2023. The new health plan cards will contain the health plan logo as well as the new Cardinal Care logo. The rebranded cards become effective no earlier than January 1, 2023.

After January 1, 2023, new Virginia Medicaid members will receive a Medicaid ID card with the Cardinal Care logo, as pictured above. You can find examples of this card, as well as the Plan First card and the Family Access to Medical Insurance Security (FAMIS) card on the DMAS Cardinal Care website for members under “Resources.” Members who need a replacement card will also receive a new Cardinal Care Medicaid card. Both the new Cardinal Care ID card and the original blue-and-white Virginia Medicaid card are valid for use for claims processing.

Visit the Cardinal Care for Members webpage, or the Cardinal Care for Providers webpage for more information.

In April 2022, DMAS introduced Provider Services Solution (PRSS), a new portal to manage provider enrollment. Medicaid providers use the PRSS portal, located on the Medicaid Enterprise System (MES) website, to complete enrollment. All Medicaid managed care network providers must enroll through PRSS to satisfy and comply with federal requirements in the 21st Century Cures Act.

Providers can initiate enrollment through the new PRSS enrollment site. Go to “Enroll as a new provider, or check your enrollment status.” Only one enrollment application is necessary in PRSS, even if a provider participates with more than one Managed Care Organization (MCO).

The application process allows for selection of one or more MCO plans. Once approved, providers must create an online PRSS portal account in order to revalidate their enrollment, make changes to personal or business information, and check member eligibility. You can find helpful training resources on the MES website.

Note: Network providers currently enrolled as fee-for-service in Medicaid do not need to re-enroll in PRSS.

The deadline for some Medicaid members to change their health plan for any reason is rapidly approaching. Commonwealth Coordinated Care Plus (CCC Plus) members and adults who receive coverage through Medicaid expansion have until December 31, 2022, to change their health plan through open enrollment. For CCC Plus members, open enrollment starts October 1 and ends December 31, 2022. For others, open enrollment starts November 1 and ends December 31, 2022. Members should have received a letter by mail with their specific dates and a plan selection packet.

Health plans offer added benefits, including vision, hearing and phone services. Members should consider what benefits are important to them and select a plan that best meets their needs. No action is needed if a member chooses to stay with their current plan.

For more information or to compare health plan options, visit the CCC Plus website or visit the Virginia Managed Care website.