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It defines contract scope, applicable laws, operational memoranda, reporting and documentation duties, and contractor responsibilities for responding to departmental requests. It also specifies MCO operational obligations, including licensure, quality and NCQA accreditation permissions and milestones, authorization to do business, nondiscrimination, continuity of operations, readiness reviews, member experience and surveys, and organizational, staffing, and call center 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is the contract term for the Cardinal Care Managed Care Contract?","Question",{"text":112,"@type":113},"The contract term runs from July 1, 2025 through June 30, 2026.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which areas are covered under the contract scope?",{"text":117,"@type":113},"The scope covers applicable laws and interpretations, operational memoranda and guidance documents, collaboration to advance state priorities, required reporting and documentation, contractor response requirements, and department oversight.",{"name":119,"@type":110,"acceptedAnswer":120},"What operational requirements does the MCO have to meet?",{"text":121,"@type":113},"The MCO must meet requirements related to licensure and solvency, quality certification and NCQA accreditation permissions and milestones, authorization to do business in Virginia, nondiscrimination, continuity of operations, readiness reviews, member experience and provider surveys, organizational and staffing requirements, and call center requirements.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},471378,1791364586,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":66,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":133,"file_id":134,"file_url":135,"file_type":136,"file_size":137,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":138,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},4398046744996,"COMMONWEALTH OF VIRGINIA DEPARTMENT OF MEDICAL ASSISTANCE SERVICES  \nCardinal Care Managed Care Contract  \nJuly 1, 2025 – June 30, 2026  \nCARDINAL CARE MANAGED CARE CONTRACT  \nContents  \n1 SCOPE OF CONTRACT..................................................................................................................1  \n1.1 Applicable Laws, Regulations, and Interpretations ................................................................... 2  \n1.2 Operational Memoranda, Guidance Documents, and Department Forms .............................. 3  \n1.3 Department and Managed Care Plan Collaboration to Advance State Priorities ..................... 3  \n1.3.1 Child Welfare Stakeholder Collaboration ........................................................................... 5  \n1.3.2 Department’s 360 Degree Review ...................................................................................... 5  \n1.3.3 Juvenile Justice Re-entry Program ...................................................................................... 6  \n1.3.4 Emergency Room Utilization Program ................................................................................ 6  \n1.4 Required Reporting and Documentation .................................................................................. 6  \n1.5 Contractor Requirements to Respond ...................................................................................... 6  \n1.5.1 Requirements to Respond to Requests Regarding Liens .................................................... 7  \n1.6 Department Oversight............................................................................................................... 8  \n2 MCO REQUIREMENTS FOR OPERATION .......................................................................................8  \n2.1 Licensure and Solvency ............................................................................................................. 8  \n2.2 Certification of Quality .............................................................................................................. 9  \n2.3 National Committee for Quality Assurance Accreditation ........................................................ 9  \n2.3.1 NCQA Permission to Notify the Department ...................................................................... 9  \n2.3.2 NCQA Milestones .............................................................................................................. 10  \n2.4 Authorization to Conduct Business in the Commonwealth .................................................... 10  \n2.5 Policy of Nondiscrimination .................................................................................................... 10  \n2.6 Continuity of Operations Plan ................................................................................................. 11  \n2.6.1 Notification to Department of COOP Implementation..................................................... 11  \n2.6.2 Business Continuity/Disaster Recovery ............................................................................ 12  \n2.7 Contractor Readiness Reviews ................................................................................................ 12  \n2.8 Member Experience and Provider Surveys ............................................................................. 14  \n2.9 Ownership and Control Interest.............................................................................................. 14  \n2.9.1 Required Disclosures of Ownership .................................................................................. 14  \n2.9.2 Required Use of DMAS 1513 Form ................................................................................... 15  \n2.9.3 Proposed Acquisition and Purchase/Sale of Health Plan ................................................. 16  \n2.10 Organizational Structure and Personnel Requirements ......................................................... 17  \n2.10.1 Managed","cbCaiim5iFKLLuo3","https://ap.wps.com/l/cbCaiim5iFKLLuo3","pdf",5324313,676,"English","# Contents\n## 1 SCOPE OF CONTRACT\n### 1.1 Applicable Laws, Regulations, and Interpretations\n### 1.2 Operational Memoranda, Guidance Documents, and Department Forms\n### 1.3 Department and Managed Care Plan Collaboration to Advance State Priorities\n### 1.4 Required Reporting and Documentation\n### 1.5 Contractor Requirements to Respond\n### 1.6 Department Oversight\n## 2 MCO REQUIREMENTS FOR OPERATION\n### 2.1 Licensure and Solvency\n### 2.2 Certification of Quality\n### 2.3 National Committee for Quality Assurance Accreditation\n### 2.4 Authorization to Conduct Business in the Commonwealth\n### 2.5 Policy of Nondiscrimination\n### 2.6 Continuity of Operations Plan\n### 2.7 Contractor Readiness Reviews\n### 2.8 Member Experience and Provider Surveys\n### 2.9 Ownership and Control Interest\n### 2.10 Organizational Structure and Personnel Requirements\n### 2.11 Changes to Contractor Organizational Structure and Operations\n### 2.12 Member and Provider Call Centers\n### 2.13 Dual-Eligible Special Needs Plans (D-SNPs)\n### 2.14 Language, Translation, and Interpretation Requirements\n### 2.15 Suspected or Known Abuse","[{\"question\":\"What is the contract term for the Cardinal Care Managed Care Contract?\",\"answer\":\"The contract term runs from July 1, 2025 through June 30, 2026.\"},{\"question\":\"Which areas are covered under the contract scope?\",\"answer\":\"The scope covers applicable laws and interpretations, operational memoranda and guidance documents, collaboration to advance state priorities, required reporting and documentation, contractor response requirements, and department oversight.\"},{\"question\":\"What operational requirements does the MCO have to meet?\",\"answer\":\"The MCO must meet requirements related to licensure and solvency, quality certification and NCQA accreditation permissions and milestones, authorization to do business in Virginia, nondiscrimination, continuity of operations, readiness reviews, member experience and provider surveys, organizational and staffing requirements, and call center requirements.\"}]","Cardinal Care Managed Care Contract - July 1, 2025 - June 30, 2026 | PDF",1790778942,1704]