More Medicaid Resources

As of the writing of this post (July 2022), the Public Health Emergency (PHE) has NOT yet ended and is set to expire in October 2022 but will probably be extended further.

When it does end, some provider flexibilities will end (including non-in-person assessments).  Something else that will happen is called Unwinding.  During the PHE, no one is being dropped from Medicaid, even if their income increases past the threshold.  But when the PHE ends, some people will lose Medicaid benefits = unwinding.  You will find a link to the PHE Unwinding Toolkit here:  https://coverva.org/content/dam/digital/united-states/virginia/cover-va/pdf/en/525_Toolkit_HealthPlansSA.pdf

Additionally, providers can find PHE unwinding information and FAQs on the Cover VA website here: https://coverva.org/en/phe-planning
Regarding the Virginia Medicaid Provider Enrollment Services (MES), if providers need assistance or have any questions regarding MES please contact The Virginia Medicaid Provider Enrollment Services vendor, which is Gainwell Technologies out of state toll free 1-888-829-5373 or in state at 804-270-5105 to speak with a Provider Enrollment Specialist.
email: VAMedicaidProviderEnrollment@gainwelltechnologies.com
Did you know you can become a preferred provider with an MCO?  Reach out to the MCOs you work with and present your case on why you need to become a preferred provider.  How can you help the MCOs reach their goals with the state?  One way is to look here – HEDIS measures: https://www.dmas.virginia.gov/data/managed-care-hedis-dashboards/
Also look in your contract for Performance Improvement Projects (PIP).

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