Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.

Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
2101 East Jefferson Street
Rockville, MD 20852
Telephone: (301) 816-2424
Fax: (301)816-7119
Member Services: (800) 777-7902
Provider Services: (877) 806-7470

Web site: kp.org

Key Staff
President: Kim Horn
Medical Director: Bernadette Loftus, MD Associate Exec. Director of the Mid-Atlantic Permanente Medical Group
Provider Relations and Contracting: Cheryl Toland, Dir., Appeals &  Network Service Administration
Government Relations: Laurie Kuiper, Sr. Director, Gov’t. Relations

Other Contacts
General Company Information: Scott Weier, Sr. Dir., Corporate Communications
Grievance/Appeals Procedures: Cheryl Toland, Dir., Appeals & Network Service Administration
Quality Improvement: Joan Gelrud, VP, Quality, Regulatory, and Risk
Pharmacy Benefits: Megan Famodu, Pharmacy Benefits Manager Provider Contracting: Steven Gulla, Dir., Provider Facility Contracting

Specialized Health Care Services
Service In-House Contracted
Mental Health X
Pharmacy Benefit Mgmt.  x-MedImpact; OptumRx
Vision Care X
Dental Care  x-Dominion National
Disease Mgmt. X
Utilization Mgmt. X


Market Segment
Market Segment HMO/POS PPO (Flex)
Individual X
Small Group (2-49 Employees) X  X
Large Group (50+ Employees) X  X
Administrative Services Only (ASO) X


Network Providers Under Contract (numbers are combined HMO/PPO)
Network Providers HMO PPO  PAR
PCPs 152  252
Physician Specialists 332  2,606
Hospitals 3  8
OB/GYNs 57  145


Enrollment (as of February 28, 2017:  263,138)
Standard HMO 221,293
Point-of-Service (POS) 4,135
Medicare Cost 22,375


Virginia HMO Service Area:
Arlington, Caroline, Culpeper, Fairfax, Fauquier, Hanover, King George, Loudoun, Louisa, Orange, Prince William, Spotsylvania, Stafford, Westmoreland

Alexandria City, Fairfax City, Falls Church City, Fredericksburg City, Manassas City, Manassas Park City