April 21, 2022

Virginia: MES update for managed care-only network providers

The Virginia Medicaid Department of Medical Assistance Services (DMAS) is in the process of transitioning several functions handled through its current Medicaid Management Information System (MMIS) to a new technology platform. This change is part of the new Medicaid Enterprise System (MES) project.

To ensure a smooth process, DMAS is scheduling enrollments in MES in phases for managed care-only providers.

Your managed care organization(s) will send you a schedule in the coming months telling you when to take this action. You will only need to enroll once even if you participate in more than 1 managed care network.

What this means for you
Providers who are contracted exclusively with Medicaid managed care network plans and do not serve fee-for-service members do not need to take action in preparation for MES at this time.

Providers who serve only Medicaid members in managed care health plans will begin enrolling in the new Provider Services Solution (PRSS) portal in June 2022. Providers will access PRSS through the new MES website.

Dually-enrolled providers
Providers who are dually enrolled with the Virginia Medicaid agency to serve fee-for-service members and also contract with managed care health plans to serve managed care members are already receiving separate instructions from DMAS on how to prepare for the transition to MES.

Dually-enrolled providers will not need to re-enroll or take any additional steps to enroll in the PRSS system at this time. Providers who were active as primary account holders in the current MMIS will receive new credentials for MES this month.  We will provide additional instructions soon on this process.

We strongly encourage these primary account holders to establish delegates and delegate administrator access for the provider as soon as possible. Providers who do not receive primary account holder credentials can request an account by filling out a form on the MES website.

Have questions about the MES project and how it affects providers? Please visit the MES website to review Frequently Asked Questions and answers about provider claims, enrollment and training.