MedicaidAdministrativeMedium impact
[Virginia] Ensuring 24/7 member access: after‑hours rules for primary care practices
Anthem BCBS·VA·Provider Bulletin
Effective date
Jul 1, 2026
We identified it
Jul 2, 2026
Summary
HealthKeepers, Inc. (Anthem) is reminding Virginia Medicaid primary care providers of mandatory 24/7 after-hours access requirements. Providers must ensure answering services or personnel can forward calls to PCPs/on-call providers within 30 minutes, screen for emergencies, provide interpreter access, and maintain multilingual answering machine messages. This is an enforcement notice of existing compliance requirements, effective July 1, 2026.
Action Required
By July 1, 2026: Billing and administrative teams must audit current after-hours protocols to ensure compliance with HealthKeepers requirements. Front desk and answering service staff must verify: (1) Call forwarding procedures reach PCP or on-call provider within 30 minutes or answering service instructs member of callback timeframe; (2) Emergency screening protocol is in place to instruct members to dial 911 immediately; (3) Telephone interpreter access is available for language barriers; (4) Answering machine messages include emergency instructions (dial 911), callback instructions for non-emergencies, and messages in English, Spanish, and any other language appropriate to practice population. Providers should document current compliance status and remediate any gaps before the July 1, 2026 effective date. HealthKeepers, Inc. conducts annual Provider Access and Availability Surveys to assess compliance; non-compliance may impact credentialing and contract status. Refer to Anthem HealthKeepers Plus care provider manual at https://anthem.com/va/provider (Resources tab) for detailed requirements.