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COVID-19 Flexibility Updates Through July 20, 2021

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Memo
Effective Date:

To:
All Providers Participating in the Virginia Medicaid and FAMIS Programs
From:
Karen Kimsey, Director Department of Medical Assistance Services (DMAS)

This memo sets out interim guidance from the Department of Medical Assistance Services (DMAS) to extend federal authorities that allow regulatory flexibilities to providers during the public health emergency (PHE) presented by COVID-19. 

The PHE was recently extended until July 20, 2021.  Each of the flexibilities extended in the March 5, 2021 memo (available here) are now extended until July 20, 2021.  Normal DMAS policies and procedures are in effect for any flexibilities not discussed in the March 5, 2021 memo.

By law, a PHE is limited to a 90-day period however, in a letter to state Governors, President Biden indicated that the PHE "will likely remain in play for the entirety of 2021." Moreover, states were assured in this letter that the U.S. Department of Health and Human Services will provide states with 60 days' notice prior to making the decision to terminate the PHE or let it expire. 

As more information is received on the federal and state public health emergencies, DMAS will provide additional updates through future memos. Providers are encouraged to frequently access the DMAS website to check the central COVID-19 response page for both frequently asked questions (FAQs) and guidance regarding these flexibilities, as well as ongoing flexibilities for behavioral health and addiction recovery treatment services, at http://www.dmas.virginia.gov/#/emergencywaiver.

For additional questions about this memo or other COVID-19 related issues, the agency has created a centralized point of access for submission at http://dmas.virginia.gov/contactforms/#/general Questions may also be submitted to COVID-19@dmas.virginia.gov

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PROVIDER CONTACT INFORMATION & RESOURCES

Virginia Medicaid Web Portal Automated Response System (ARS)

Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice.

Visit: www.virginiamedicaid.dmas.virginia.gov

Medicall (Audio Response System)

Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice.

Call: 1-800-884-9730, or

1-800-772-9996

KEPRO

Service authorization information for fee-for-service members.

Visit: https://dmas.kepro.com/

 

Managed Care Programs

Medallion 4.0, Commonwealth Coordinated Care Plus (CCC Plus), and Program of All-Inclusive Care for the Elderly (PACE).  In order to be reimbursed for services provided to a managed care enrolled individual, providers must follow their respective contract with the managed care plan/PACE provider.  The managed care plan may utilize different guidelines than those described for Medicaid fee-for-service individuals.

Medallion 4.0

Visit: http://www.dmas.virginia.gov/#/med4

CCC Plus

Visit: http://www.dmas.virginia.gov/#/cccplus

PACE

Visit: http://www.dmas.virginia.gov/#/longtermprograms

Magellan Behavioral Health

Behavioral Health Services Administrator, check eligibility, claim status, service limits, and service authorizations for fee-for-service members.

Visit: http://www.magellanhealth.com/Provider

For credentialing and behavioral health service information:

Visit: www.magellanofvirginia.com

Email: VAProviderQuestions@MagellanHealth.com

Call: 1-800-424-4046

 

 

Provider HELPLINE

Monday–Friday 8:00 a.m.-5:00 p.m.  For provider use only, have Medicaid Provider ID Number available.

Call: 1-804-786-6273, or

1-800-552-8627

Aetna Better Health of Virginia

Visit: www.aetnabetterhealth.com/virginia

Call: 1-800-279-1878

Anthem HealthKeepers Plus

Visit: www.anthem.com/vamedicaid, or

Call: 1-800-901-0020

Magellan Complete Care of Virginia

Visit: www.MCCofVA.com 

Call: 1-800-424-4518 (TTY 711), or

1-800-643-2273

Optima Family Care

Call: 1-800-881-2166 www.optimahealth.com/medicaid

United Healthcare

Visit: www.uhccommunityplan.com/VA, or

www.myuhc.com/communityplan

Call: 1-844-752-9434, TTY 711

Virginia Premier

Call: 1-800-727-7536 (TTY: 711), www.virginiapremier.com