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

The MCHIP unit within the Acute Care Division is responsible for monitoring compliance with the Rules and Regulations for Certification of Quality Assurance for Managed Care Health Insurance Plan Licensees (12VAC5-408). The unit issues certificates of quality assurance to licensed MCHIPS, conducts onsite compliance reviews, and investigates enrollee complaints regarding the quality of care received from their managed care provider.

The division certifies Managed Care Health Insurance Plans (MCHIPS) and registers Private Review Agents (PRAs).  In addition, the division inspects of Clinical Laboratories participating in the federal Clinical Laboratory Improvement Amendments (CLIA) program.