{"id":40,"date":"2016-07-20T18:12:59","date_gmt":"2016-07-20T18:12:59","guid":{"rendered":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/?page_id=40"},"modified":"2025-08-11T10:39:41","modified_gmt":"2025-08-11T14:39:41","slug":"managed-care-health-insurance-plan-mchip-and-private-review-agents-pra","status":"publish","type":"page","link":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/managed-care-health-insurance-plan-mchip-and-private-review-agents-pra\/","title":{"rendered":"Managed Care Health Insurance Plan (MCHIP) and Private Review Agents (PRA)"},"content":{"rendered":"
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Please be advised that if you are having challenges sending your renewal or initial application(s) through CD-Rom or USB, the application may be sent through secured email to MCHIP@vdh.virginia.gov<\/a>. Please indicate on your email that the appropriate fee is being sent separately.<\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div>

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The MCHIP\/PRA unit is within the Office of Licensure and Certification of the Virginia Department of Health.<\/p>\n

The MCHIP \/PRA unit recognizes NCQA and URAC as acceptable accrediting bodies. Other insurance carriers that are not NCQA and URAC accredited will be reviewed for \u00a0the 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, or a dental plan organization.<\/p>\n

The responsibilities of the MCHIP\/PRA unit include issuing Certificates of Quality Assurance (CQA) for initial and renewal insurance plan applications with coordination with the Bureau of Insurance in the State Corporation Commission and investigating complaints from covered persons that it receives by email, postal mail and telephone.<\/p>\n

For general assistance, email us at MCHIP@vdh.virginia.gov<\/a>. Please send any mailed correspondence to:<\/p>\n

MCHIP\/PRA Unit
\nOffice of Licensure and Certification
\n9960 Mayland Drive, Suite 401
\nHenrico, VA 23233<\/p>\n

The MCHIP\/PRA unit also reviews the annual Insurance Complaint report, which is due every March for each MCHIP carrier.<\/p>\n

For more information regarding the MCHIP\/PRA statutes and regulations, please visit our Statutes, Regulations & Guidance<\/a> page.<\/strong><\/p>\n<\/div>\n<\/div><\/div><\/div>

Quick Links<\/h3>\n
\n\t

NCQA Health Plan Report Card<\/a><\/p>\n

CQA Application Status<\/a><\/p>\n

MCHIP Annual Notice 2020<\/a><\/p>\n

Application for a Certificate of Quality Assurance (11-2019)<\/a><\/p>\n

Questions to Exclude Based on NCQA Certification<\/a><\/p>\n

PRA Application<\/a><\/p>\n

MCHIP Geographic Service Area Change Worksheet<\/a><\/p>\n

MCHIP Enrollee Complaint Form<\/a><\/p>\n

MCHIP Annual Complaint Form<\/a><\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div>

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\n\t\t\t\t\t\tDivision Contacts\t\t\t\t\t\t<\/h3>\n\t\t\t\t\t\t\t\t\t\t\t
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<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n<\/div><\/div>
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Leslie Moore<\/strong>
\n<\/em>MCHIP\/PRA Supervisor<\/em>
\nPhone: (804) 367-2128
\nleslie.moore@vdh.virginia.gov<\/a><\/p>\n<\/div>\n<\/div><\/div><\/div>

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Tara McFadden
\n<\/strong>Health Care Compliance Specialist II
\n<\/em>Phone: (804) 367-2140
\nTara.McFadden@vdh.virginia.gov<\/a><\/p>\n<\/div>\n<\/div><\/div><\/div>

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Yolanda Morrison
\n<\/strong>Health Care Compliance Specialist II
\n<\/em>Phone: (804) 367-6628
\nYolanda. Morrison@vdh.virginia.gov<\/a><\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"

Please be advised that if you are having challenges sending your renewal or initial application(s) through CD-Rom or USB, the application may be sent through secured email to MCHIP@vdh.virginia.gov. Please indicate on your email that the appropriate fee is being sent separately. The MCHIP\/PRA unit is within the Office of Licensure and Certification of the […]<\/p>\n","protected":false},"author":52,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"no","_lmt_disable":"","footnotes":""},"tags":[],"class_list":["post-40","page","type-page","status-publish","hentry"],"yoast_head":"\nManaged Care Health Insurance Plan (MCHIP) and Private Review Agents (PRA) - Licensure And Certification<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/managed-care-health-insurance-plan-mchip-and-private-review-agents-pra\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Managed Care Health Insurance Plan (MCHIP) and Private Review Agents (PRA) - Licensure And Certification\" \/>\n<meta property=\"og:description\" content=\"Please be advised that if you are having challenges sending your renewal or initial application(s) through CD-Rom or USB, the application may be sent through secured email to MCHIP@vdh.virginia.gov. 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