Credential MDs

09/01/2025

07/01/2025

Cardinal Care New Health Plan Contracts Launch TODAY
What's Changing
Cardinal Care’s Health Plans:
Aetna Better Health of Virginia
Anthem HealthKeepers Plus
NEW Humana Healthy Horizons of Virginia
Sentara Community Plan
United Healthcare of the Mid-Atlantic, Inc
New contracts and rates that include new GA initiatives
New plan programs and initiatives
New enhanced services
Humana Healthy Horizons of Virginia is CCMC’s new MCO. Molina will no longer be available. Molina members will move to Humana.
Providers can begin contracting with Humana now
Model of care – with a stronger focus on member centered care, with holistic and responsive care management
Anthem HealthKeepers Plus will serve as a single statewide Foster Care Specialty Plan (FCSP) for children and youth in foster care, adoption assistance members, and individuals with former foster care eligibility
What's Staying the Same
One managed care program, one contract.
Benefits and Services: No reductions in benefits and services. Existing service authorizations issued by DMAS or the previous health plan will be honored for a minimum of 30 days or otherwise specified in the Cardinal Care contract.
Enrollment: Providers are required to enroll and periodically revalidate directly with DMAS through its provider services solution (PRSS) portal. Newly enrolled members will be in FFS for a short time prior to enrollment in a health plan.

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05/20/2025

Molina will no longer be a Medicaid replacement plan as of 07/01/2025. Molina patients will be transitioned to Humana Medicaid.

As of July 1, 2025 Virginia Medicaid will have the following Managed Care Plans: Aetna Better Health, Anthem HealthKeepers Plus, Humana Healthy Horizons of Virginia, Sentara Community Plan, and UnitedHealthCare Community Plan.

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05/25/2024

MDs will be closed on Monday, May 28th in celebration of 🇺🇲

05/05/2024

04/12/2024

Humana is replacing Molina starting Summer 2024

Virginia awarded Medicaid managed care contracts to five insurers.

According to a Feb. 29 news release from the state's Department of Medical Assistance Services, Aetna, Humana, Anthem, UnitedHealthcare and Sentara Health Plans were awarded contracts to administer the state's Medicaid program beginning in summer of 2024.

In a Feb. 29 news release, Molina Healthcare said its Virginia contract was not renewed. Molina currently manages care for 140,000 Virginia Medicaid beneficiaries.

Molina is evaluating next steps, according to the release.

https://www.beckerspayer.com/contracting/virginia-awards-medicaid-contracts-molina-loses-out.html #:~:text=According%20to%20a%20Feb.,beginning%20in%20summer%20of%202024.

10/01/2023

Starting January 1, 2024 Medicare will start credentialing LPCs!!

10/10/2022

The credentialing process 🤷🤷