Virginia Department of Medical Assistance
Virginia Department of Medical Assistance Services (DMAS) is a state government agency administering Virginia Medicaid for over 2 million residents through Cardinal Care managed care and fee-for-service programs.
- Company typePrivate
- Founded1985
- HeadquartersRichmond, United States
- Headcount1–10
- GTM typeB2C
- OfferingServices
What Virginia Department of Medical Assistance does
Virginia Department of Medical Assistance Services (DMAS) is a state government agency of the Commonwealth of Virginia that administers Virginia Medicaid, serving over 2 million residents through the Cardinal Care managed care program and a fee-for-service delivery system. Effective July 2025, DMAS consolidated the former CCC Plus and Medallion 4.0 programs into a unified Cardinal Care program offering five Managed Care Organization (MCO) health plan options: Aetna Better Health of Virginia, Anthem HealthKeepers Plus, Humana Healthy Horizons of Virginia, Sentara Health Plans, and UnitedHealthcare Community Plan. The agency also operates specialized products including FAMIS (Virginia's CHIP), the Foster Care Specialty Plan (administered by Anthem HealthKeepers Plus), the ARTS substance use disorder program under a 1115 Demonstration Waiver, and Home and Community-Based Services waivers (CCC Plus, Developmental Disability Waivers), as well as a Community Doula Program and 12-month postpartum coverage extension.
DMAS runs a multi-platform technology infrastructure for member and provider interactions, including the Medicaid Enterprise System (MES) portal for providers, the Virginia Cardinal Care Mobile App on iOS and Android, the CoverVA public enrollment portal, the Maximus-operated Cardinal Care Enrollment Broker (mobile app, virginiamanagedcare.com, and 1-800-643-2273 helpline), a redesigned DMAS member website serving 120,000+ users, and the Baby Bot system that automatically enrolls over 1,000 newborns in Medicaid each month. The agency's revenue model is a federal-state partnership: DMAS receives federal matching funds (approximately 50-70% federal match) plus state appropriations and pays contracted MCOs via capitation while reimbursing FFS providers directly under published rate schedules.
The agency is led by Agency Director Steve Ford and operates from its Richmond headquarters at 600 East Broad Street. It is currently defending a federal lawsuit from fifteen Federally Qualified Health Centers alleging 25 years of underpayment under the Prospective Payment System, and is managing provider-side transitions including Fishing Point Healthcare's April 15, 2026 service pause for Medicaid members. Recent strategic priorities include the Provider Services Solution (PRSS) initiative with Gainwell and the MCOs, the Rural Health Transformation program, and the rollout of the Beneficiary Advisory Council.
Virginia Department of Medical Assistance firmographics
Firmographics- Name
- Virginia Department of Medical Assistance
- Legal name
- Virginia Department of Medical Assistance Services
- Website
- https://dmas.virginia.gov
- Company type
- Private
- Founded year
- 1985
- Operating status
- Operating
- Headcount range
- 1–10 employees
- Short description
- Virginia Department of Medical Assistance Services (DMAS) is a state government agency administering Virginia Medicaid for over 2 million residents through Cardinal Care managed care and fee-for-service programs.
- Ownership category
- akta.pro rank
Virginia Department of Medical Assistance industry classification
Industry- Product category
- Government Medicaid Administration
- NAICS
- Health and Welfare Funds (52512)
- SIC
- Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- TANF/CHIP Managed Care Plans (HLAEAEAA)
- akta.pro secondary industries
- Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH), Medicaid/CHIP Dental & Vision Benefits Administration (FSAIAHAK)
Keywords
Where Virginia Department of Medical Assistance is headquartered
LocationHeadquarters
- HQ city
- Richmond
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Virginia Department of Medical Assistance business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Infrastructure, Marketing or Sales, Others
Revenue model
- Medicaid Managed Care Capitation: DMAS operates as a state Medicaid agency receiving federal and state funding to administer Medicaid. The agency contracts with Managed Care Organizations (MCOs) who receive capitation payments to provide healthcare services to enrolled members. Revenue comes from federal matching funds (approximately 50-70% federal match rate) and state appropriations based on program enrollment and services provided.
- Fee-for-Service Medicaid: For members not enrolled in managed care, DMAS reimburses providers directly for covered services under the fee-for-service model. Rates are set through the Rates and Rate Setting process, including procedure fee files, hospital rates, nursing facility rates, and outpatient EAPG pricing.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Annual | Virginia Medicaid eligibility is based on income, household size, disability status, age, and other factors per federal and state guidelines. |
Go-to-market motion1 record
Distribution channels7 records
Marketing channels8 records
Virginia Department of Medical Assistance product offering
Product offeringCore offering
DMAS administers Virginia's Medicaid and CHIP programs, providing healthcare coverage to over 2 million Virginians through the Cardinal Care managed care program (with five MCO health plan options) and fee-for-service delivery. The agency funds and oversees benefits across medical, behavioral health, dental, prescription, long-term care, transportation, and maternal/child health services for eligible children, pregnant individuals, low-income adults, and aged/blind/disabled populations.
Product overview
Virginia Department of Medical Assistance Services (DMAS) operates Virginia Medicaid, a government-funded healthcare program serving over 2 million Virginians. The program offers a unified Cardinal Care managed care system (consolidated from previous CCC Plus and Medallion 4.0 programs as of July 2025) with five health plan options through Managed Care Organizations. Core products include coverage for children (Medicaid for Children, FAMIS), pregnant women, adults aged 19-64, and aged/blind/disabled individuals. Specialized programs include Long Term Care, Behavioral Health/ARTS, Dental (Cardinal Care Smiles), Prescription Drugs, Transportation, School Based Services, and various waivers (CCC Plus, Developmental Disability Waivers). Member-facing digital products include the CoverVA enrollment portal, Cardinal Care Enrollment Broker, Virginia Cardinal Care Mobile App, MES Portal for providers, and Provider Search Portal. The agency also administers the 1115 Demonstration Waiver, Rural Health Transformation Initiative, and Foster Care Specialty Plan.
Differentiator
Problem solved
Functional benefit
Brands
- Cardinal Care: Virginia's Medicaid managed care program that connects members to healthcare services
Products and services
- Cardinal Care Managed Care Program Virginia's unified Medicaid managed care program connecting over 2 million members to healthcare services through five MCO health plan options (Aetna Better Health of Virginia, Anthem HealthKeepers Plus, Humana Healthy Horizons of Virginia, Sentara Health Plans, and United Healthcare Community Plan). Provides medical services, behavioral health, nursing facility services, and community-based long-term care waivers.
- FAMIS (Family Access to Medical Insurance Security) Virginia's Children's Health Insurance Program (CHIP) providing health coverage for children in families with income above Medicaid eligibility thresholds but below specified limits. FAMIS members gained access to the Cardinal Care Enrollment Broker in 2025.
- Medicaid for Children Health coverage program for children under Virginia Medicaid, including preventive services, behavioral health, dental, and prescription benefits for eligible children from birth through age 18.
- Medicaid for Pregnant Women / Cardinal Care Pregnancy and Postpartum Coverage Coverage for pregnant individuals including prenatal care, delivery, and postpartum services up to 12 months under Cardinal Care Pregnancy and Postpartum Coverage, including FAMIS MOMS and FAMIS Prenatal programs.
- Adults 19-64 Medicaid Health coverage for adults aged 19-64 who meet income and eligibility requirements under Virginia Medicaid, including ACA expansion population.
- Medicaid for Aged, Blind, or Disabled (ABD) Coverage for individuals who are aged (65+), blind, or disabled, including Medicare Savings Programs (QMB, SLMB, QI) and SSI-related Medicaid with spend-down programs.
- Plan First Limited Medicaid program covering birth control and family planning services to help prevent unplanned pregnancies for eligible men and women in Virginia.
- Long Term Care Services Nursing facilities, specialized care, long-stay hospitals, home health, and Home and Community Based Services (HCBS) waiver services for eligible Medicaid members in Virginia.
- Behavioral Health Services (including ARTS) Mental health services, Addiction and Recovery Treatment Services (ARTS), and substance use disorder treatment covered under Virginia Medicaid with mobile crisis services capability.
- Dental Services (Cardinal Care Smiles) Comprehensive dental coverage for both adults and children under Cardinal Care Smiles, including services for foster care members and pregnant members.
- Prescription Drug Coverage Medicaid Managed Care, Dual Special Needs Plans, and Virginia Medicaid Preferred Drug List (PDL) Fee-for-Service prescription coverage for eligible members.
- Transportation Services Non-emergency medical transportation covered when Medicaid members have no other way to get to doctor appointments or covered Medicaid services.
- School Based Services Physical, occupational and speech therapy, audiology, psychological services, and other school-based health services covered under Virginia Medicaid.
- Cardinal Care Enrollment Broker Enrollment platform providing three ways for Virginia Medicaid and FAMIS members to learn about managed care health plans, compare provider networks, and change plans via mobile app, virginiamanagedcare.com website, and toll-free helpline (1-800-643-2273).
- Virginia Cardinal Care Mobile App Free mobile application available on iOS and Android for Virginia Medicaid members to access Cardinal Care information, compare health plans, manage coverage, and find providers.
- Baby Bot Automatic Newborn Enrollment Automated system that identifies and enrolls eligible newborns in Virginia Medicaid at birth without manual application processing.
- Foster Care Specialty Plan Specialized health plan administered by Anthem HealthKeepers Plus providing additional supports for Virginia members in foster care, adoption assistance, or who aged out of foster care under age 26.
- 1115 Demonstration Waiver (ARTS and Former Foster Care) Federal CMS-approved waiver program including Addiction and Recovery Treatment Services (ARTS) and Former Foster Care coverage under Virginia's Medicaid demonstration.
- CCC Plus Waiver Commonwealth Coordinated Care Plus Waiver providing home and community-based services for individuals who need nursing facility level of care.
- Developmental Disability (DD) Waivers Waiver programs including Building Independence (BI), Family and Individual Supports (FIS), and Community Living (CL) waivers for individuals with developmental disabilities in Virginia.
- Rural Health Transformation Initiative Virginia initiative to improve healthcare in rural communities through needs assessment, best practices sharing, and innovative solutions to expand access to high-quality, affordable care across the Commonwealth.
- Community Doula Program Program providing doula support services to pregnant Medicaid members to improve birth outcomes and maternal health in Virginia.
- Premium Assistance Programs (HIPP and FAMIS Select) Programs including Health Insurance Premium Payment (HIPP) and FAMIS Select that help members pay for employer-sponsored insurance or other coverage.
- PACE (Program of All-Inclusive Care) Program providing comprehensive medical and social services to eligible individuals age 55 and older who need nursing home level of care but wish to remain in the community.
Quantifiable outcome
- Postpartum visit rates increased from 46% (2021) to 55% statewide; in Petersburg from 42% to 64%
- +4 more outcomes
Companies that use Virginia Department of Medical Assistance
Customer profileNamed customers1 record
Segments7 records
Ideal customer profiles5 records
Virginia Department of Medical Assistance technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature3 records
Virginia Department of Medical Assistance partnerships and signals
Strategic signalPartnerships
Ten partnerships are on record, tiered core and minor.
- Aetna Better Health of VirginiacoreAetna Better Health of Virginia is one of five Managed Care Organizations (MCOs) contracted to provide Cardinal Care managed care services. Provides health plan options for Medicaid and FAMIS members covering medical services, behavioral health, nursing facility services, and community-based long-term care waivers.
- Anthem HealthKeepers PluscoreAnthem HealthKeepers Plus serves as both a standard MCO and administrator of the Foster Care Specialty Plan for foster care youth, adoption assistance recipients, and former foster care individuals under age 26. Provides comprehensive Medicaid managed care services.
- Humana Healthy Horizons of VirginiacoreHumana Healthy Horizons of Virginia joined Cardinal Care as the newest MCO option effective July 1, 2025. Previously, Molina members were automatically moved to Humana. Provides managed care health plan services for Medicaid members.
- Sentara Health PlanscoreSentara Health Plans provides managed care health plan options under Cardinal Care for Virginia Medicaid members. Covers medical services, behavioral health, nursing facility services, and waiver services.
- United Healthcare Community Plan of the Mid-AtlanticcoreUnited Healthcare Community Plan provides managed care health plan services under Cardinal Care for Virginia Medicaid members. Offers coverage for medical services, behavioral health services, nursing facility services, and community-based long-term care.
- Fishing Point Healthcare and Affiliated PharmaciesminorHealthcare provider network that has decided to pause services for Virginia Medicaid members effective April 15, 2026. DMAS is assisting affected members in finding alternative enrolled healthcare providers through the Member Helpline and MCO contacts.
- Maximus (Enrollment Broker)coreMaximus operates as the Cardinal Care Enrollment Broker, providing three enrollment channels: Virginia Cardinal Care Mobile App, virginiamanagedcare.com website, and helpline (1-800-643-2273). Previously only served Medicaid members; now also serves FAMIS members.
- Gainwell (MES Vendor)coreGainwell Technologies is referenced in DMAS Provider Services Solution (PRSS) efforts, working with DMAS and MCOs to help providers resolve managed care network issues. Operates MES portal for provider enrollment and claims processing.
- Virginia Department of Social ServicescoreVDSS partners with DMAS to administer Medicaid eligibility and renewal processes. Local departments of social services complete annual renewals automatically when they have sufficient information, or mail paper forms when additional information is needed.
- Virginia Department of HealthminorVDH coordinates with DMAS on public health emergencies, winter weather advisories, and health initiatives including the Rural Health Transformation program and mobile crisis services.
Scale indicators8 records
Recent moves6 records
Expansion highlights6 records
Virginia Department of Medical Assistance competitors and assessment
Company assessmentMarket position
Competitive moat4 records
Key highlights7 records
Customer concentration
Virginia Department of Medical Assistance social profiles
Digital presenceVirginia Department of Medical Assistance financial estimates
Financial estimateRevenue estimate
Valuation estimate
Virginia Department of Medical Assistance leadership team
Management profileNumber of profiles
Profiles2 records
Virginia Department of Medical Assistance funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Virginia Department of Medical Assistance M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Virginia Department of Medical Assistance
What does Virginia Department of Medical Assistance do?
DMAS administers Virginia's Medicaid and CHIP programs, providing healthcare coverage to over 2 million Virginians through the Cardinal Care managed care program (with five MCO health plan options) and fee-for-service delivery. The agency funds and oversees benefits across medical, behavioral health, dental, prescription, long-term care, transportation, and maternal/child health services for eligible children, pregnant individuals, low-income adults, and aged/blind/disabled populations.
Is Virginia Department of Medical Assistance a public or private company?
Virginia Department of Medical Assistance is a private company. It is classified as state government owned and is currently operating.
When was Virginia Department of Medical Assistance founded?
Virginia Department of Medical Assistance was founded in 1985. It employs 1 to 10 people.
Where is Virginia Department of Medical Assistance based?
Virginia Department of Medical Assistance is headquartered in Richmond, United States, in the North America region.
How does Virginia Department of Medical Assistance make money?
Two revenue lines are on record. Medicaid Managed Care Capitation is the primary driver. The others are fee-for-Service Medicaid.
Does Virginia Department of Medical Assistance have an API?
No public API is recorded for Virginia Department of Medical Assistance.
What industry is Virginia Department of Medical Assistance in?
Virginia Department of Medical Assistance's product category is Government Medicaid Administration. Its primary akta.pro industry code is HLAEAEAA, TANF/CHIP Managed Care Plans, with a secondary code of BPAIAKAH, Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage). Its NAICS code is 52512 and its SIC code is 6324.