[Virginia] Access surveys for primary care practitioners, specialty care practitioners, and behavioral health practitioners

By August 1, 2026: Front office and scheduling staff must implement the following access standards: (1) Schedule routine preventive appointments within 60 calendar days; (2) Schedule urgent care appointments (acute symptoms) within 24 hours; (3) Schedule routine check-ups within 10 business days for PCPs; (4) For OB/GYN and oncology specialties, schedule routine appointments within 30 calendar days; (5) For behavioral health, schedule non-life-threatening emergencies within 6 hours, urgent services within 24 hours, initial routine appointments within 10 business days, and follow-up routine appointments within 30 calendar days. Additionally, all practitioners must establish 24/7 after-hours coverage with live voice or recorded message directing members to urgent care, 911, ER, or connecting them to an on-call provider—answering machines referencing only ER/911 are non-compliant. Immediately: Update telehealth information on Availity.com to ensure accurate directory listings. Before July 1, 2028: Ensure provider directory reflects which physicians offer covered telehealth services. Document reasons if standards cannot be regularly met. Failure to comply may result in negative member satisfaction scores, increased grievances, and potential contract sanctions based on vendor monitoring.