The Centers for Medicare and Medicaid Services (CMS) recently approved DMAS's application to operate a single managed care program through Cardinal Care Managed Care, effective October 1, 2023. Cardinal Care Managed Care includes all existing managed care populations and services, maintains enrollment of the member with their current MCO, and provides a strong foundation for the Governor’s priority initiatives, including Right Help, Right Now and the Managed Care Procurement.

The transition to Cardinal Care Managed Care is expected to be seamless for members and providers. Members and providers do not need to take any action to enroll in Cardinal Care; members remain enrolled with their health plan and can continue to see their current providers. Cardinal Care Managed Care also improves the members’ experience by eliminating a drop to fee-for-service when members transition from Medallion to CCC Plus (or vice versa). Mitigation of gaps in the member’s managed care organization (MCO) enrollment also leads to improved claims and service authorization transactions.

DMAS was directed to merge the two managed care programs as part of the 2021 Appropriations Act. DMAS proceeded with the initial phase to rebrand as Cardinal Care in January 2023, and worked diligently to obtain CMS approval of the consolidated managed care waiver. New ID cards with the Cardinal Care logo were issued, and the consolidated enrollment broker website and aligned regional open enrollment process were implemented January 1, 2023.

While the new contract is effective October 1, 2023, full implementation, including systems and operational changes, may require 30 to 60 days. DMAS recently shared a formal announcement to providers via the October 17, 2023 Medicaid Memo and updated information on our websites.

Over the next few months, DMAS will phase out use of the CCC Plus and Medallion 4.0 managed care program names, although the CCC Plus long-term services and supports home and community-based services (HCBS) Waiver will continue to operate as CCC Plus HCBS.  

This impressive milestone was not possible without the efforts of many who have supported the Cardinal Care project. Thank you to all those who helped create a clearer path to care for our members.