Virginia Medicaid Takes Provider Appeals Online Only From Nov. 5. Fax Stops Jan. 1

DMAS makes its AIMS portal the only filing route for provider appeals, including DMAS review of final MCO decisions, just as an ABA hours cap waits on CMS.

Virginia's Department of Medical Assistance Services said in an October 2 bulletin that new regulations take effect on November 5, 2026, making its online appeals portal, AIMS, the only way a provider can file an appeal. Mail, email and fax keep working through the end of 2026. From January 1, 2027, anything sent those ways won't be processed unless DMAS has granted a good-cause exception.

That's 26 days to the rule and 83 days to enforcement.

Why ABA providers should care now

It reads like back-office housekeeping. For ABA in Virginia, the timing is what matters. The draft Mental Health Services Manual we covered on September 30 would add a 20-hour weekly limit and an F84.0 diagnosis requirement once CMS approves state plan amendment 26-018. If that happens, more reduced and denied authorizations will need appealing, and they'll run into a filing rule that's changing at the same moment.

This covers Cardinal Care plans as well as fee-for-service. DMAS's appeals portal page tells managed care network providers to work through the MCO's internal appeal first. To have DMAS review the final MCO decision, they file the next level in AIMS.

What the bulletin says

  • November 5, 2026: the regulations take effect, and Chapter II of every provider manual is revised the same day. The General Assembly directed the change in Item 292 QQ of the 2025 Appropriation Act.
  • Through December 31, 2026: DMAS keeps accepting appeals by all methods.
  • From January 1, 2027: documents received by mail, delivery, email or fax aren't processed unless they come with a good-cause request that DMAS grants.
  • Exceptions must be requested before the appeal deadline, by mail or by email to appeals@dmas.virginia.gov, with the subject "Exception Request for Portal Filing." The bulletin gives three examples of good cause: no infrastructure for electronic filing in the provider's region, a disability affecting all of the provider's staff, or "unusual or unavoidable circumstances."
  • Registration isn't instant. To comply with HIPAA, DMAS has to verify that each person registering is affiliated with the provider, and it tells staff to register as soon as they receive the bulletin.

The limits

Appeal deadlines don't change. Under 12VAC30-20-540, an informal appeal of most DMAS decisions is still due within 30 days of receipt. The rule binds providers only: members, applicants and their authorized representatives requesting State Fair Hearings can still file by other methods. AIMS itself isn't new: it launched in May 2021, and filing there is already allowed.

What you must know or do

Owners and billing leads: name the people who file your Medicaid appeals, including any outside biller, and have each one register for AIMS this month at appeals-registration.dmas.virginia.gov/provider. Since DMAS verifies every registration, a request made the week an appeal is due may not clear in time.

Pull every open appeal and every MCO internal appeal still pending. Any that could reach DMAS after January 1 needs to be filed in AIMS.

Give a copy of the bulletin to your billing contractor. It covers contractors who file for you.