CCC Locality Participation Update

As previously reported in the CareConnection, the Department of Medical Assistance Services (DMAS) has agreed to update and post a more user-friendly Commonwealth Coordinated Care (CCC) Locality Coverage Status table developed by VHCA.  Status is based first on the locality being in a demonstration region, and secondly, by the number of Medicare/Medicaid Plans (MMPs) with network coverage in the locality.  DMAS has not yet begun posting the table (we will communicate when that has occurred and how to access it online), but they did provide the following updates:

  • Radford City is now eligible for passive (automatic) enrollment with two MMPs (HealthKeepers and Humana).  Eligible recipients who have not already opted-out of the CCC program in Radford will receive their initial CCC enrollment letter September 1, indicating coverage to be effective November 1 (60 day notice).  
  • Martinsville and Henry County recipients will be able to opt-in to CCC effective next week.  Humana has achieved network coverage in these two localities, allowing participation for opt-in coverage only.
  • There are no DMAS-reported changes for Northern Virginia.  If current MMP network coverage does not change in the next week or so, only three localities (Culpeper County, Prince William County and Manassas City) will be eligible for passive (automatic) enrollment with effective coverage November 1.  As MMP network coverage increases, localities will switch to passive enrollment status in subsequent months.  Recipients in such localities will be given 60 days notice prior to effective coverage.  Keep in mind that residents in this region may choose to enroll in CCC; automatic enrollment is currently limited to the three localities listed above.

Attached is the updated table to reflect the DMAS-announced changes (highlighted in yellow).  Again, locality participation status can change based on MMP network adequacy; it is important to check status periodically.  Once posted, DMAS will be the source of this information.  Until then, we will continue to alert you to changes as they are announced by DMAS.