Page 7 – The reviewer determines that providers have documentation from Magellan of Virginia (FFS only) stating that they are in compliance with DMAS marketing requirements.
Recommend that this language be removed as it not only creates a delay in distributing marketing material but is also in conflict with information shared from a DMAS training in 2019. A review of marketing materials could be included in DMAS audits, to include audit contractors, to ensure compliance with marketing guidelines.
(08) Amendments to Marketing Requirements: This fast-track regulatory action amends the marketing rules found in 12 VAC 30-130-2000 to clarify that Community Mental Health (CMH) providers no longer need to submit their marketing plans and materials to DMAS for review. This requirement does not make sense for providers who are operating under the oversight of a Managed Care Organization (MCO) and is also being eliminated for fee-for- service (FFS) providers in order to ensure that providers have the same requirements no matter whether they operate in an MCO or in FFS. Most CMH providers are moving into MCOs and will be complying with MCO contract requirements related to marketing practices. This regulation is essential to protect the health, safety, and welfare of citizens in that it prevents rules that were originally designed for fee-for-service providers from applying to MCO providers. To require MCO providers to submit marketing materials and marketing plans to DMAS for approval would interfere with the oversight responsibilities of the MCO. It is essential that MCO providers remain in compliance with their MCO contract requirements, and repealing this regulation ensures that providers will have one set of rules to follow so that Medicaid members are provided with only appropriate marketing materials using appropriate marketing practices. Internal DMAS review for this project began on 4/5/18. Following that review, the regs were submitted to the OAG on 7/17/18. The regs were OAG-certified on 12/28/18; submitted to DPB for review on 1/2/19/18; and forwarded to HHR on 2/11/19. The EIA response was requested on 2/11/19. DMAS posted the agency EIA response on 2/13/19. The project was forwarded to the Gov. Ofc. for review on 4/14/19. The regs were forwarded to the Registrar on 6/5/19; published in the Register on 6/24/19 with a comment period ending on 7/24/19; and became effective on 8/7/19.
