Virginia’s Title XXI Child Health Insurance Plan (CHIP) covers children with family income from 143% to 200% FPL under a separate child health plan known as the Family Access to Medical Insurance Security Plan (FAMIS). Virginia’s Title XXI Health Insurance Flexibility and Accountability (HIFA) Demonstration has two objectives. 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. Virginia’s current HIFA Demonstration ends June 30, 2016. The Department of Medical Assistance Services (DMAS) proposes to extend the Demonstration for three additional years, through June 30, 2019, and is seeking public comment on this proposal.
The purpose of the FAMIS MOMS program is to provide prenatal care to uninsured women living within the Title XXI income range and likely to give birth to a FAMIS-eligible child. Consistent with Title XXI requirements, to be eligible for FAMIS MOMS a pregnant woman must be uninsured, a citizen or lawfully residing immigrant, and not be an inpatient in an institution for mental diseases or an inmate in an institution that is not a medical facility. The FAMIS MOMS program provides eligible pregnant women the same comprehensive coverage that pregnant women receive from the Virginia Medicaid program. There is no difference in covered services, service limitations, or pre-authorization requirements. Like Medicaid, there are no premiums of copayments required. FAMIS MOMS uses the same health care services delivery systems (fee-for-service and managed care organizations) as FAMIS.
The Code of Virginia provides an option for children eligible for FAMIS to be enrolled in employer-sponsored health insurance (ESHI) and for DMAS to contribute to the cost of ESHI for eligible dependent children if deemed cost effective to the Commonwealth. With FAMIS Select, the family of a FAMIS enrolled child may enroll the child in their employer’s health insurance program or a private health insurance plan and be reimbursed up to $100 per month per eligible child, not to exceed the amount of the premium. The child then receives the health care services provided by the private/employer-sponsored health plan, using that health plan’s provider network, and the family is responsible for any costs associated with that policy.
Public Review and Comment
The full Public Notice and the preliminary Demonstration Extension Application will be available for public review on April 25, 2015 from the Department of Medical Assistance Services, Division of Maternal and Child Health, 600 East Broad Street, 7th floor, Richmond, VA 23219 and on the Internet from the Department of Medical Assistance Services home page at http://dmasva.dmas.virginia.gov/ through a link in the What’s New column and from the Cover Virginia web site.
DMAS is seeking comments on the preliminary application. Anyone wishing to submit comments may do so to Joanne Boise by mail at Department of Medical Assistance Services, Division of Maternal and Child Health, 600 East Broad Street , Richmond, VA 23219 or by e-mail to firstname.lastname@example.org. In order to be considered, comments must be received by June 5, 2015.
DMAS will convene two public hearings to seek public input on the Demonstration Extension Application. Both oral and written comments may be submitted at that time.
Public Hearing #1:
When: May 7, 2015, 10:00 am
Where: Virginia Department of Medical Assistance Services
600 East Broad Street
Richmond, Virginia 23219
Conference Call Option: 1-866-842-5779 Passcode: 2761019567
Public Hearing #2:
When: June 4, 2015, 1:00 pm
Where: Quarterly Children’s Health Insurance Advisory Committee Meeting
Virginia Community Healthcare Association
Westerre Conference Center
3831 Westerre Parkway
Henrico, VA 23233