Commonwealth Coordinated Care Update

The Department of Medical Assistance Services (DMAS) and the Center for Medicare and Medicaid Services (CMS) will move Commonwealth Coordinated Care (CCC) automatic enrollment for the Northern VA region from October 1, 2014 to November 1, 2014.  Eligible individuals in the Northern Virginia region will continue to voluntarily enroll in CCC through October and, for those who do not opt-in to CCC or opt-out of CCC, their automatic coverage with CCC will begin November 1, 2014.  Letters informing eligible individuals of their upcoming automatic assignment will be received by September 1, 2014, sixty days prior to the effective coverage change.  The delay in automatic assignment will ensure network sufficiency with the Medicare-Medicaid Plans (MMPs), giving the health plans additional time to expand and diversify their provider networks.  The change also maximizes beneficiary choice by increasing provider options.

Launch of the Commonwealth Coordinated Care Program

Yesterday was the official start of the Commonwealth Coordinated Care Program (CCC) in the Tidewater Region of Virginia with a significant number of dual eligible individuals "passively" enrolled in the program.  According to the Department of Medical Assistance Services (DMAS) yesterday, this includes just under 1,400 nursing facility residents. VHCA has been working diligently with DMAS and the Medicare-Medicaid Plans (MMPs) to ensure a successful launch of the program.  However, there are still many issues to be resolved.  While we are working through those we want to ensure that members are communicating any issues as soon as possible to the MMPs and VHCA.  At VHCA's request, DMAS has created a one-page quick reference guides for each of the three MMPs:  

The guides include important contact information and resources for claims submission and authorizations.  This information is also available on the DMAS website.
VHCA would also like to be aware of any issues you are having.  Once you contact the plans, please take a few moments to fill out the issue form and email it directly to VHCA via Kathy Robertson.  We are working to get this form online for ease of use by our members, and will notify you when it is available, but do not wait - please use the attached form and send it in.  If you have any other issues or prefer to speak with someone directly, please call 804.353.9101.   
Please direct any questions to the CCC Inbox.      

July 16th CCC Training Opportunity

The Department of Medical Assistance Services (DMAS) recently announced a training opportunity on the Commonwealth Coordinated Care (CCC).  DMAS is partnering with the Center for Health Care Strategies to offer half-day workshops that will give providers additional information about the new CCC program that blends Medicare and Medicaid services and benefits for individuals.  Workshop attendees will hear a national update on this initiative to align Medicare and Medicaid services across the country, a state update on CCC implementation, presentations from the three Medicare-Medicaid Plans (MMPs) providing care under CCC, and information about beneficiary rights.  Providers can expect to learn more about processes for authorizations, billing, and care management through the MMPs.  Please click here for the workshop agenda.
The morning workshop is geared towards nursing facility and personal care providers, and the afternoon session will focus on Service Facilitators.  Space is limited, so please RSVP your attendance as soon as possible to the CCC team via email.