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Medicaid News & Updates

Federal Work Requirement

Beginning in January 2027, a new federal law requires adults enrolled in Medicaid Expansion to work or do other activities (such as volunteering or participating in a work training or education program) for at least 80 hours a month, unless exempt, to qualify for Medicaid Expansion coverage.  These same adults will also have their coverage reviewed every 6 months, instead of every 12 months.  Who must meet the new Medicaid work requirement?  The new requirement applies only to members enrolled in Medicaid Expansion. Medicaid Expansion covers individuals who are between 19 and 64, have income under 138% of the federal poverty level (FPL), and are not eligible for Medicare. Most Medicaid covered adults in this age range are in Medicaid Expansion.   This requirement DOES NOT apply to children, pregnant or postpartum individuals, or adults with a disability or who are over 65.    How will someone know if they are enrolled in Medicaid Expansion?  Medicaid Expansion members will be mailed a notice by the end of September 2026 telling them about the new requirement. They can also call Cover Virginia at 855-242-8282, or contact their local Department of Social Services.  What must a member do to comply with this new requirement?  The new requirement can be fulfilled in a few different ways. Individuals can:  Work, participate in a work program, attend school, and/or volunteer for at least 80 hours a month in total. Work can include both in-kind and unpaid work, such as receiving free or reduced cost housing as compensation for work.   Be enrolled in school (including high school, GED program, higher education, career, and technical education) at least half time. Have monthly income that is at least equal to $580. (For a seasonal worker, the average income over 6 months must be equal or higher than $580.)   Who can be exempt from the new requirements?  Some Medicaid Expansion members may be exempt, including:  People with blindness or a disability, such as those receiving Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI)  People who are pregnant or within 12 months of the end of a pregnancy  Former foster care youth who are 25 or younger  Parents and caregivers of a child age 13 and younger, or a person of any age with a disability Veterans with a 100% disability rating Members of federally recognized tribes People who have a serious or complex medical condition that makes it difficult to meet the requirement, including a behavioral health condition or developmental disability that significantly impairs a person’s ability to perform 1 or more activity of daily living (such as bathing, dressing, feeding themselves or using the bathroom) People who are incarcerated, or were released from incarceration in last 3 months

Last Call for Central VA Members! Open Enrollment Closes June 30

Explore the Provider Manuals Library

Did you know that the Medicaid Enterprise System (MES) portal offers a library for various provider manuals?

The following Manuals can be found on the MES Portal: 

• Mental Health Services Manual 
• Psychiatric Services Manual
• Residential Treatment Services Manual 
• Addiction and Recovery Treatment Services Manual 

To explore the full Provider Manuals Library, visit the link below. 

Check Out the Medicaid Adult Dental Benefit Forecasting Tool

Providing dental care to Medicaid beneficiaries can be professionally fulfilling for many dentists. The Medicaid Adult Benefit Forecasting tool is designed to give oral health providers the ability to forecast practice capacity and revenue from existing patients with change in coverage who will be newly eligible for coverage as well as revenue from new patients with first-time dental coverage. By understanding enrollment and reimbursement policy, patient engagement, and adoption of structured processes and operations, practices can integrate Medicaid participation without compromising standards. To learn more about this tool, visit the link below.

What's Happening Around the Commonwealth?

Governor Spanberger Signs Queen Candis Act Into Law, First-in-the-Nation Package to Transform Sickle Cell Care

On June 11, Governor Abigail Spanberger signed a first-in-the-nation, comprehensive legislative package focused on improving education, training, access, and coordinated care for Virginians with sickle cell and their families. The Queen Candis Act was created in memory of Candis Gabriella King — a brilliant, vibrant 15-year-old whose passing sparked a unified effort to protect and uplift others battling sickle cell disease. At Sentara Community Care Center in Newport News, the Governor celebrated the life and advocacy of Candis together with her parents — Joshua King and Secretary of the Commonwealth Candi Mundon King — and the entire King family while signing the new legislation into law. The bipartisan legislative package Governor Spanberger signed into law supports parents, teachers, and healthcare professionals in managing, recognizing, and treating sickle cell disease. The new laws create greater training for school nurses across Virginia on sickle cell disease and support high school coaches in identifying the risks for student-athletes with the sickle cell trait. Additionally, the Governor signed legislation to establish Virginia's first sickle cell trait awareness and education program and create the Virginia Sickle Cell Coordinated Access Network to connect healthcare providers with real-time consultation from sickle cell specialists.

Governor Spanberger Announces Virginia Workforce Initiative Wins National Economic Development Award 

On June 5, Governor Abigail Spanberger celebrated InternshipsVA — a statewide initiative to strengthen the Commonwealth's workforce by connecting students with paid internships in Virginia — winning a Business Facilities 2026 Economic Development Organization (EDO) award. 

The annual EDO awards recognize innovative programs across America that help communities attract business investment, create jobs, and strengthen workforce development.

InternshipsVA provides technical assistance and financial support to Virginia employers interested in creating or expanding internship programs for undergraduate students in Virginia. The initiative has helped more than 250 employers apply for matching grants to create more than 600 internships in its first four months.

Governor Spanberger Signs Bills to Protect Patients & Medical Professionals from Violence at Hospitals

On June 4, Governor Abigail Spanberger signed legislation to make Virginia hospitals and medical facilities safer for patients, their families, and the nurses, doctors, and medical professionals who serve Virginia communities. 

Alongside legislators, healthcare professionals, and local leaders at Sentara Norfolk General Hospital, Governor Spanberger signed House Bill 229 and Senate Bill 173, prohibiting firearms and other dangerous weapons inside medical facilities that provide mental health and developmental services. 

Governor Spanberger Marks Start of 2026 Atlantic Hurricane Season, Urges Virginians to Prepare

On June 3, Governor Abigail Spanberger urged all Virginians to take steps now to prepare their homes, businesses, and communities for potential severe weather this summer and fall following the official June 1 start of the 2026 Atlantic hurricane season in Virginia.

At the Virginia Emergency Operations Center, Governor Spanberger convened Virginia Department of Emergency Management (VDEM) personnel, public safety leaders, and senior administration officials for a tabletop exercise to strengthen interagency coordination and statewide preparedness. Additionally, the Governor highlighted the ongoing training and collaboration by government agencies, first responders, community organizations, and private sector partners ahead of hurricane season.

Hurricane season runs from June 1 through November 30, with the greatest risk for Virginia typically occurring from late summer into early fall. Tropical systems can bring damaging winds, flooding rains, tornadoes, storm surge along the coast, and prolonged power outages far inland. Emergency officials stress that preparation before a storm develops is the most effective way to stay safe.

Governor Spanberger Signs Legislation to Create State Internship Coordinator, Expand Opportunities to More Students

On June 10, Governor Abigail Spanberger signed bipartisan legislation creating Virginia’s first State Internship Coordinator — a new role within her Administration focused on strengthening state internship programs and expanding internship opportunities in government agencies to more Virginia students in every corner of the Commonwealth.

In Richmond, the Governor was joined by student interns from across state agencies and the 2026 Governor’s Fellows to sign Senate Bill 286 and House Bill 54 — patroned by Senator Lashrecse Aird and Delegate Rip Sullivan — and highlight her continued focus on making sure every Virginian entering the workforce has the opportunity to find a stable, successful career.

Connect With Us

Upcoming Meetings & Events

Want to stay updated on the agency? The Virginia Department of Medical Assistance Services (DMAS) hosts many public meetings every month that you are welcome to attend.

For more information about these meetings, visit the Upcoming Meetings page on our website. 

July 9 | 10:00 a.m.

Pharmacy Liaison Committee Meeting

July 16 | 1:00 p.m.

Pharmacy and Therapeutics Meeting

July 17 | 10:00 a.m.

CHIPAC Executive Subcommittee Meeting

July 17 | 11:00 a.m.

CHIPAC Federal Impact Monitoring Subcommittee Meeting

Engage With Your Cardinal Care Community!

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