Pursuant to 42 CFR § 431.408, DMAS is providing notice of intent to submit to the federal Centers for Medicare and Medicaid Services (CMS) a request to extend for five years its Title XXI Health Insurance Flexibility and Accountability (HIFA) Section 1115 Demonstration Waiver for the FAMIS MOMS and FAMIS Select programs.
Virginia is requesting the same waiver and expenditure authorities as those approved in the current Demonstration period. For the FAMIS MOMS and FAMIS Select populations, all CHIP and Medicaid rules not expressly waived or identified as not applicable shall apply.
Virginia’s Title XXI Children’s Health Insurance Program (CHIP) covers children with family income from 143% to 200% of the federal poverty level (FPL) under a separate child health plan known as the Family Access to Medical Insurance Security (FAMIS) Plan. Virginia’s Title XXI Health Insurance Flexibility and Accountability (HIFA) Demonstration has two components. First, it expands Title XXI coverage to uninsured pregnant women with family income up to 200% of the federal poverty level (FPL) who are not eligible for Medicaid, through a program known as FAMIS MOMS. Second, it uses Title XXI funds to support a health insurance premium assistance program known as FAMIS Select. Children must first be found eligible and enroll in FAMIS before electing to receive coverage through FAMIS Select.
The goals of Virginia’s Title XXI HIFA Demonstration are as follows:
For FAMIS MOMS:
- Facilitate access to prenatal, obstetric, and postpartum care for a vulnerable population that does not otherwise qualify for public insurance;
- Improve selected birth outcomes of FAMIS MOMS participants and their newborns;
- Improve access to and use of health care services that promote inter-conception health for FAMIS MOMS participants;
- Facilitate access to recommended pediatric primary care for newborns of FAMIS MOMS participants.
For FAMIS Select:
- Facilitate access to affordable private and employer-sponsored health insurance for low-income families through premium assistance;
- Ensure that access to and use of health care services available to children participating in FAMIS Select is comparable to that of children participating in FAMIS;
- Assure the aggregate cost-effectiveness of the FAMIS Select program.
In June 2016, Virginia received approval to continue operating the FAMIS MOMS and FAMIS Select programs under this Demonstration Waiver. The extension, which expires on June 30, 2019, includes the following agreements:
- Virginia will continue to provide coverage with federal reimbursement at the CHIP rate for pregnant women without creditable insurance coverage in families with income through 200% FPL.
- Virginia will continue to use Medicaid methodology for determining income eligibility.
- Virginia will continue to provide coverage for FAMIS MOMS that is identical to coverage provided to pregnant women under the Medicaid State Plan.
- Virginia will continue to deem infants born to FAMIS or FAMIS MOMS enrollees eligible for CHIP or Medicaid coverage for the first year of life.
The DMAS website includes a detailed public notice with more information about the extension request as well as the draft waiver renewal application. See http://www.dmas.virginia.gov/#/hifawaiver. Public comments may be submitted until midnight (Eastern Time) on Thursday, December 13, 2018. Public comments may be submitted by e-mail to firstname.lastname@example.org or by regular mail or in person at the address below.
Virginia Department of Medical Assistance Services
HIFA Waiver Renewal Application Public Comment
Attn: Hope Richardson
600 East Broad Street
Richmond, VA 23219
DMAS will hold two public hearings at the times and locations below, where verbal or written public comments can also be submitted. To give verbal comments at public hearings, individuals will need to sign up in advance on a sign-up sheet available at the public hearing. All verbal public comments should be limited to two minutes each.
Public Hearing #1:
Friday, November 30, 2018, 10:00-11:00 AM
Department of Medical Assistance Services
600 East Broad Street
Seventh Floor, Room 7B
If unable to attend in person, you may join by phone by calling 1-866-842-5779, then entering passcode 0961028985, followed by #.
Public Hearing #2:
Thursday, December 6, 2018, 1:00-4:30 PM
Quarterly Children’s Health Insurance Program Advisory Committee (CHIPAC) meeting
Virginia Community Healthcare Association
Westerre Conference Center
3831 Westerre Parkway
After considering public comments about the proposed waiver renewal application, DMAS will make final decisions about the waiver and submit a revised application to CMS. The summary of comments, as well as copies of written comments received, will be posted for public viewing on the DMAS website along with the waiver extension application when it is submitted to CMS.
For more information about the FAMIS MOMS and FAMIS Select Demonstration, which the Commonwealth is seeking to extend, please visit the CMS website at https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/?entry=8648.