Managed Care Health Insurance Plan (MCHIP) and Private Review Agents (PRA)

The MCHIP/PRA area is within the Office of Licensure and Certification of the Virginia Department of Health.

The MCHIP /PRA area recognizes NCQA and URAC as acceptable accrediting bodies. Other insurance carriers that are not NCQA and URAC, will be reviewed for  the reliability and validity of the accreditation, as well, as whether it is nationally recognized to determine if it meets the required standards. No insurance carrier shall operate a MCHIP in Virginia unless the health carrier responsible for the plan is licensed in accordance with provisions of Title 38.2 of the code of Virginia as an insurance company, a HMO, a dental plan organization.

The responsibilities of the MCHIP/PRA area range from issuing Certificates of Quality Assurance (CQA) for initial and renewal insurance plan applications with coordination with the Bureau of Insurance.

The MCHIP/PRA unit researches concerns from covered persons by email, United States mail and telephone.

Finally, the MCHIP/PRA reviews the annual Insurance Complaint report which is due every March.

For more information regarding the MCHIP/PRA regulations, please refer to the law.lis.virginia.gov links below: 
MCHIP Regulation Title 12 Agency 5 Chapter 408
PRA Regulation Title 12 Agency 5 Chapter 405

For additional information, please review our quick links.

Division Contacts

Leslie Moore
MCHIP/PRA Supervisor
Phone: (804) 367-2128
leslie.moore@vdh.virginia.gov
    Responsibilities:
Management level escalations

Evelyn Hardwick
Health Care Compliance Specialist
Phone: (804) 367-2140
evelyn.hardwick@vdh.virginia.gov
    Responsibilities:
 – PRA Renewal and initial applications
– Complaint inquiries
– A
nnual Complaint Report
– Monitoring of MCHIP general email

Noordin Abbamin
Health Care Compliance Specialist
Phone: (804) 367-6628
noordin.abbamin@vdh.virginia.gov
    Responsibilities:
Check Deposits for MCHIP/PRA applications
Process of all MCHIP renewal and initial applications

For General Assistance, email us at MCHIP@vdh.virginia.gov
Please send any mailed correspondence to:
MCHIP/PRA Division
Office of Licensure and Certification
9960 Mayland Drive, Suite 401
Henrico, VA 23233