The eligibility categories excluded from Medallion 4.0 are CCC Plus participants, people in domestic and community services (HCBS), members of the age, blind and disability (ABD) category (including ISS), co-op entitled holders, all-inclusive elderly care programs (CAPC) and a number of smaller and limited benefit categories, as indicated in the call for tenders. This week, our “In Focus” section is reviewing the Virginia Department of Medical Assistance (DMAS) Tender for the Medallion 4.0 Medicaid Medical Care Program. Medallion 4.0 will serve approximately 740,000 children, including those with special health needs, families, and individuals in care and adoption programs, with annual Medicaid managed care spending of more than $3 billion, if fully implemented by the end of 2018. The proposals were presented on 8 September 2017 to be sent to the DMAS. Medallion 4.0 will also mark the beginning of Medicaid Managed care plans, which would cover and coordinate new services such as early intervention and non-traditional behavioral health services previously removed from Medallion 3.0. At Aetna Better Health of Virginia, we focus on operational excellence. We strive to eliminate redundancies and streamline processes for the benefit and value of all our partners. Below are some of the reasons providers have opted to partner with us in managed healthcare: The Medallion 3.0 program currently offers Medicaid Managed Care to approximately 784,000 members in seven regions of the state. However, approximately 86,000 current Medallion 3.0 members will switch to the new Commonwealth Coordinated Care Plus (CCC Plus) program on January 1, 2018. CCC Plus, a separate Medicaid Managed care program that provides long-term care and services and supports, was purchased last year through a separate tender. In February 2017, DMAS awarded CCC Plus contracts to six MCOs: Aetna Better Health of Virginia, Anthem HealthKeepers Plus, Magellan Complete Care of Virginia, Optima Health, United Healthcare and Virginia Premier Health Plan.

With the exception of United and Magellan Complete Care, all selected plans are included in the Medallion 3.0 plan. Starting in August 2017, DMAS will begin implementing the new CCC Plus program, which will offer approximately 214,000 older adults, as well as children and adults with disabilities, long-term services and support (LTSS). After full implementation, Medallion 4.0 will cover nearly 740,000 Medicaid and FaMIS eligible members, including infants, children, and adults in the LiFC (Low Income Families with Children) group, pregnant women, FAMIS MOMS, care and adoption assistance, children with special health needs, and adolescents. . . .