Information on Contract Requirements for Medicaid Managed Care Organizations

The purpose of this Medicaid Memo is to describe contract requirements that the Department of
Medical Assistance (“DMAS”) has with Medicaid Managed Care Organizations who provide
services to Virginia Medicaid recipients. This memo does not restate each contract requirement.
Instead, this memo underscores the contractual obligations for DMAS contracted Commonwealth
Coordinated Care Plus (“CCC Plus”) and Medallion 4.0 MCOs to ensure all federal and state
regulations regarding the managed care grievance and appeal system contained in state and federal
regulations codified in 12 VAC 30-120-4201 and §§42 CFR 438.400 – 42 CFR 438.424
( ) are followed
throughout the MCO appeal processes…

Read the Full Medicaid Memo