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Virginia launches Cardinal Care (CCMC) July 1; special enrollment, foster-care specialty plan, model-of-care changes explained
Summary
The Department of Medical Assistance Services outlined the Cardinal Care Managed Care (CCMC) reprocurement, an updated model of care and a new foster care specialty plan that take effect July 1, 2025. DMAS and MCOs explained enrollment windows, continuity-of-care protections and provider resources during a June provider Q&A.
The Department of Medical Assistance Services (DMAS) said Cardinal Care Managed Care (CCMC), a reprocurement and consolidation of Virginia’s Medicaid managed care program, goes into effect July 1, 2025, and will not reduce covered benefits or change the populations eligible for Medicaid.
DMAS facilitator Michelle Watts said the program consolidates previously separate managed care waivers and contracts and adds a stronger, member-centered model of care that emphasizes interdisciplinary care teams, tiered care-management intensity (low, moderate and high) and greater coordination of medical and nonmedical needs such as housing and food access. Watts also summarized the department’s top goals for Cardinal Care, including improved provider access, reduced administrative burden and a foster-care specialty plan.
The foster-care specialty plan will be operated statewide by Anthem HealthKeepers Plus for children and youth in foster care, adoption-assistance cases and individuals with former-foster-care eligibility, DMAS and Anthem representatives said. Anthem said the specialty plan will provide dedicated care-management supports for medical and behavioral needs and tailored benefits for youth in foster care.
DMAS said a special CCMC enrollment period runs June 19–Sept. 30, 2025, during which members may compare plans and select a managed-care organization (MCO). Members who do not select a new plan will remain in their current plan as of July 1. Molina members who move to Humana Healthy Horizons will be enrolled effective July 1 and have a 90-day window from that date to change plans, DMAS staff and Humana said.
DMAS and MCO speakers stressed there will be no reductions in covered services and that existing service authorizations will be honored during an initial continuity period. Humana and DMAS clarified during the Q&A that continuity of care for prior authorizations in the Molina-to-Humana transition will be 60 days; the slide deck had earlier stated 30 days, and DMAS acknowledged and clarified the longer period during the session.
Providers were told they must remain enrolled with DMAS through the state’s PRSS (provider services solution portal) and may need to contract with up to five MCOs to participate fully across the program. DMAS staff and the MCOs said provider-facing materials, training schedules, contact lists and the recording of the education session would be posted to the DMAS Cardinal Care provider page.
The session reiterated that Cardinal Care’s model of care is intended to make care coordination responsive to member needs rather than solely to eligibility category or diagnosis. DMAS pointed providers to the 2025 Cardinal Care managed-care contract posted on the DMAS website for details on the model of care (the contract’s model-of-care material begins at section 8).
