Welcome to the Spring edition of the SignUpNow Outreach eNewsletter. SignUpNow (SUN) is an initiative of the Virginia Health Care Foundation (VHCF) that is focused on increasing enrollment of eligible uninsured children in Virginia's FAMIS programs. Please forward this newsletter to colleagues and encourage them to register via the "Join Our Mailing List" button to receive the SignUpNow Outreach eNewsletter themselves. |
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Farewell and Best Wishes to Judith Cash | |
 The Virginia Health Care Foundation recently bid farewell to Judith Cash. After seven years with the foundation, two as Director of Child Health Insurance Initiatives and five as Deputy Director, Judith has moved on to become the Deputy Director of the Children's Insurance Program at the Centers for Medicaid and Medicare Services in Baltimore. She is working directly under Linda Nablo (former Director of Maternal and Child Health at DMAS).
Judith oversaw the Covering Kids & Families grant at VHCF, which helped bring about many positive changes to the FAMIS programs. She was also Chair and an active member of the Children's Health Insurance Program Advisory Committee (established by the General Assembly to assess the policies, operations and outreach efforts for FAMIS and FAMIS Plus and to evaluate enrollment, utilization of services, and health outcomes of eligible children for such programs) for many years.
While we will miss Judith greatly, we congratulate her on this great opportunity, wish her all the best, and look forward to continuing to work with her on child health insurance issues at the national level. |
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Managed Care Program Expansion in Far Southwest Virginia
The DMAS managed care program is expanding to the far southwest (FSW) region of the Commonwealth effective July 1, 2012.This region includes the following localities: Bland, Buchanan, Carroll, Dickenson, Grayson, Lee, Russell, Scott, Smyth, Tazewell, Washington, Wise, Bristol, Galax and Norton.
Medicaid and FAMIS managed care participants in the FSW region will select their health plan from one of 6 participating managed care organizations (MCOs): Amerigroup Community Care, Anthem HealthKeepers Plus, Optima Family Care, MajestaCare (a health plan of Carilion Clinic), Southern Health-CareNet, and Virginia Premier Health Plan. These MCOs will provide coverage for approximately 45,000 eligible Medicaid and FAMIS individuals in the area.
This MCO Expansion into FSW region means that the MEDALLION PCCM program will end on April 30, 2012, and will no longer be an option for Medicaid/FAMIS Plus members residing in the FSW region. From May 1 - June 30, 2012, individuals currently enrolled in MEDALLION will receive coverage through the DMAS fee-for-service program. Effective July 1, 2012, managed care eligible individuals residing in one of the FSW areas will be enrolled in one of the 6 contracted MCOs.
DMAS will soon be sending notifications to all providers in these areas, including local Departments of Social Services (DSS) and local Health Departments. Affected members will begin receiving notices in May about these changes and also about planned member informational meetings, including a health fair in June (time and place to be determined). DMAS will continue to post the most up-to-date information about the MCO FSW expansion, including copies of provider and recipient communications (and provider and recipient meeting schedules) on the main Managed Care page of the DMAS website. For information on FAMIS go to the Health Plans page of the FAMIS website.
FAMIS Plus/Medicaid recipients should contact the Managed Care HelpLine at 800-643-2273 for assistance in selecting their MCO. FAMIS/FAMIS MOMS recipients should contact the FAMIS Central Processing Unit at 866-873-2647.
DMAS will also be reminding providers that some Medicaid and FAMIS individuals are not eligible to enroll in managed care, and some services are carved-out of the MCO contracts.
Procedure Change to FAMIS Select
FAMIS Select is the premium assistance program under FAMIS where families receive a payment of up to $100 for each FAMIS enrolled child that they can then apply toward the purchase of employer-based or private family health coverage.
To facilitate the family paying the premium for their health plan, DMAS has been paying two payments at the beginning of their enrollment into FAMIS Select. This enabled the family to always be using FAMIS Select dollars to pay the premium instead of paying out of pocket and waiting to be reimbursed by DMAS. Many families, however, found that this caused a financial hardship when they came off the FAMIS Select program. Since they had been paid in advance for their next month's premium, they owed this money back to DMAS.
Effective April 1, 2012, DMAS is changing the procedure to be a strict reimbursement of the costs. The family will have to pay the premium for the first month out of pocket, but when they come off the program they owe DMAS nothing.
New Team Members
The DMAS Maternal and Child Health (MCH) Division has two new staff members. Lauren Cunningham, Member Communications Coordinator, will be working with Shelagh Greenwood in the Marketing and Outreach Unit. Lauren's email is Lauren.Cunningham@dmas.virginia.gov and her phone number is 804-371-5053. Marilyn Miller is the new MCH Administrative Assistant. Marilyn can be reached at Marilyn.Miller@dmas.virginia.gov and by phone at 804-786-3712. | |
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Getting to Know CommonHelp: Helping Those In Need
In early Fall 2012 the Virginia Department of Social Services will "go live" with CommonHelp, a web-based, self-service platform for its customers. The new service is an online solution that will allow customers access to information and services 24 hours a day, seven days a week, from their homes, libraries, schools or anywhere the Internet is available to them.
Through CommonHelp customers will be able to: screen for potential eligibility; apply for benefits [including child care subsidies, SNAP/Food Stamps, Medicaid (including FAMIS), TANF and Energy Assistance]; check the status of applications; report changes; and complete benefit renewals.
The solution is being tested in several localities throughout the State of Virginia and is not currently available to the public. Look for more details on the official launch in future newsletters. |
Removal of 5-year Bar in Coverage for Legal Immigrant Pregnant Women and Children |
By Jill Hanken, Staff Attorney, Virginia Poverty Law Center
During this past legislative session, bills providing state-sponsored health coverage for legal immigrants (pregnant women up to 200% FPL and children from 134%FPL - 200%FPL) were passed. House Bill 183 and Senate Bill 568 provide Medicaid coverage for legal immigrant pregnant women during the first 5 years of lawful residence in the United States, and they also provide coverage under FAMIS for legal immigrant children and pregnant women during their first 5 years of lawful residence.
The bills change eligibility in FAMIS MOMS and Medicaid for Pregnant Women enabling the programs to provide prenatal care to about 1,000 pregnant legal immigrants with incomes below 200% of the Federal Poverty Level ($46,100 for a family of 4). It will also provide coverage for labor and delivery charges for FAMIS MOMS eligible women. (Medicaid eligible legal immigrants can already receive labor and delivery coverage as a Medicaid emergency service.)
The bill also changes eligibility in FAMIS, allowing legal immigrant children between 134-200% FPL to be covered as well. This will extend coverage to about 288 more children per year.
Prior to the passage of the federal Children's Health Insurance Program Reauthorization Act of 2009, federal reimbursement for Medicaid and FAMIS coverage of these legal immigrants had not been allowed, so these populations had been barred from coverage. Virginia had chosen to cover low income legal immigrant children in Medicaid using state-only funding. With the passage of the CHIPRA option to cover this population, federal matching funds are now available to pay for a portion of the expansion costs.
As of the date of this publication, the General Assembly had not yet passed the biennial budget. However, both the House and Senate versions of the budget include funds for implementing these bills. This indicates broad support. A final budget will likely be adopted before the July 1, 2012 effective date. | |
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Patient Protection and Affordable Care Act Turns 2! |
In March, the Patient Protection and Affordable Care Act (PPACA) turned two years old. Already, more than 817,000 Virginia children are benefiting the legislation's prohibition of lifetime limits of care, according to the Department of Health and Human Services. Although the portion of the law expanding Medicaid coverage to low income adults doesn't take effect until 2014, more than 62,800 young adults in Virginia have already benefited from the provision that allows children to stay on their family's insurance until they are 25 years of age. For more information on how PPACA has affected the Commonwealth, Healthcare.gov has a fact sheet entitled "Two Years Later: The Benefits of the Affordable Care Act for Virginia."
The US Department of Health and Human Services (HHS) has also launched a new initiative called My Care to educate Americans about PPACA through personal stories from individuals across the country. HHS has posted videos about how a particular provision of the law has impacted an individual or family. |
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In April, the Virginia Health Care Foundation will release the new Profile of Virginia's Uninsured developed by the Urban Institute. Some previews of coming attractions follow: |
- There was a 10% increase (from 912,000 to 1,004,000) in the number of Virginians without health insurance coverage between 2009 and 2010. This outpaces the 3% increase in the uninsured in the nation as a whole.
- 12.5 % of Virginia's uninsured are between the ages of 0 and 18 (approximately 125,000 children).
- About 80,000 uninsured children live in families under 200% of the federal poverty level and are potentially eligible for Virginia's FAMIS Programs.
- Adults in Virginia are 2.8 times more likely to lack coverage than children. The uninsurance rate among Virginia children aged 18 years and younger is 6.4%. In contrast, the uninsurance rate among non-elderly adults (ages 19-64) is 18% . At the national level these figures are 8% and 22% respectively.
FAMIS Program Enrollment as of March 1, 2012:
- Children enrolled in FAMIS: 64,059
- Children enrolled in FAMIS Select: 330
- Children enrolled in FAMIS Plus: 521,698*
(*includes children in the CHIP Medicaid Expansion) - Pregnant women enrolled in FAMIS MOMS: 1,496
- Pregnant women enrolled in Medicaid for Pregnant Women: 15,138
- Men and Women enrolled in Plan First: 19,655
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If you have colleagues who would benefit from receiving SignUpNow Outreach, please forward this email to them and encourage them to subscribe to our mailing list. We look forward to providing additional information on children's health insurance in the near future.
Sincerely,
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