This newsletter is made possible with support of the
- Did You Know?
- 2016 Medicaid and FAMIS Enrollment Summit
- What is an Ex Parte Renewal?
- Policy Clarification for Soon-to-Be One-Year-Old Enrollees
- Update on the Governor's A Healthy Virginia
- Policy Updates Effective July 1, 2016
- New Pediatric Dental Toolkit Available
- New Profile of Virginia's Uninsured Now Available
- FAMIS Program Enrollment Numbers
Did You Know?
- The most recent data show that 31% of applications were processed through Common Help.
- The Cover Virginia website can be viewed in 48 languages.
- Pregnant women do not need to have a verified pregnancy to enroll in FAMIS MOMS.
- 1.5 million FAMIS fliers were distributed through DMAS's Back-to-School Campaign in 2015.
2016 Medicaid and FAMIS Enrollment Summit: Building a Healthier Virginia: Covering the Commonwealth's Children
Nearly 300 attendees: including representatives from local and state Social Services, Department of Medical Assistance Services, Cover Virginia, and Application Assisters, came together for a day of networking and presentations by leading experts in the field of child health insurance.
Diane Rowland, Executive Vice President of Kaiser Family Foundation, was the keynote speaker. Ms. Rowland was followed by two panels: Keeping Kids Covered: Working with Families Through the Renewal Process and Maximizing Engagement with Latino Families.
Awards were given to individuals and organizations who have rendered exceptional service and dedication to enrolling children and pregnant women in the FAMIS programs. They are:
FAMIS Guru Extraordinaire:
FAMIS Super Stars:
- Elise M. Brown - Enroll Virginia
- Fairfax Department of Family Services - Inova Fairfax Hospital Medicaid Team and OB Clinic
- Latasha B. Henley - Cover Virginia
- The Outreach & Enrollment Team at Eastern Shore Rural Health System
The day closed with special remarks from Secretary of Health and Human Resources William Hazel. Presentations and materials distributed at the Summit are on the Cover Virginia website and can be found by clicking here.
What is an Ex Parte Renewal?
Ex Parte is the first step in renewing a child's coverage that reduces the burden for both the DSS and the family! It lets the local DSS renew an enrollee's coverage using readily available information without contacting the family. If the worker is able to verify an enrollee's information through electronic sources, an approval letter is sent to the family notifying them of the approval once the renewal is complete.
If the worker is unable to verify an enrollee's information through electronic sources, a pre-populated renewal packet will be sent to the family. The renewal packet should include the information that was available to the local DSS or Central Processing Unit, and will request any additional information needed to renew eligibility.
Families can renew their child's enrollment by: going online to CommonHelp (if an enrollee has an online account and has linked the case), calling the Cover Virginia Call Center at 1-855-242-8282, or by completing and sending in the paper renewal form.
If a case is closed for "failure to complete" the renewal, the family still has 3 months from the month of closure to provide needed information to reinstate coverage.
Policy Clarification for Soon-to-Be One-Year-Old Enrollees
Children born to mothers eligible for coverage in FAMIS or Medicaid as of the date of the child's birth are "deemed" to have applied and been determined to be eligible for coverage; no application or eligibility determination needs to be completed. These children are automatically eligible for coverage until they turn age one. As these deemed newborns approach their first birthday, a renewal of eligibility, rather than a new application and evaluation, should be completed to determine ongoing eligibility for the child. These children must be renewed using one of the available renewal methods; ex parte, on-line, call center or paper application, just as would be done for an older child.
A Healthy Virginia
In September 2014, Governor McAuliffe unveiled his 10-point Healthy Virginia plan to expand healthcare services to over 200,000 Virginians. One of the goals is to enroll 35,000 more children into the FAMIS Programs by December 31. To meet this goal, the Secretary of Health and Human Resources, Dr. William Hazel recently challenged outreach and local Department of Social Services workers in the Commonwealth to work together to enroll 2,000 more children per month until December. To access the plan, click here.
Policy Updates Effective July 2016
- Beginning July 1, eligibility for the Governor's Access Plan (GAP) increases from 60% FPL to 80% FPL. GAP integrates primary and behavioral health services and care coordination for Virginia's low income uninsured with serious mental illness (SMI). As of May 14, there are 7,465 members enrolled in GAP. For more information about GAP, please go to www.gap-va.org or call 1-855-869-8190 to apply.
- The Low-Income Families with Children (LIFC) guidelines are updated annually, effective July 1 each year. The current dollar amounts have not changed this year and will remain in effect until July 1, 2017.
- At this time, Behavioral Therapies are only covered by EPSDT for FAMIS Plus (Medicaid for Children), and Fee-for-Service FAMIS. Starting July 1, Behavioral Therapy will be a covered benefit under FAMIS, too. Behavioral Therapy covers services including, but not limited to, Applied Behavior Analysis (ABA). Behavioral Therapy is not an autism specific or ABA specific service. While ABA has been shown to be effective for autism spectrum disorders, it can also be helpful to children with other diagnoses having significant behavioral or intellectual challenges. Behavioral Therapy is designed to enhance communication skills, and decrease behaviors which, if left untreated, could lead to more complex problems. Services are designed to help the child's family manage the behavior in the home using behavioral modification strategies.
Reminder:The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid. EPSDT is key to ensuring that children and adolescents receive appropriate preventive, dental, mental health, and developmental, and specialty services. A treatment or medical need diagnosed during an EPSDT visit must be paid for by Medicaid.
New Pediatric Dental Toolkit Available
The Virginia Health Care Foundation (VHCF) has developed Brushing Up -Tooth Talk for Kids, a toolkit of entertaining and age-appropriate materials to help educate and motivate elementary school children to take care of their teeth.
These materials have been categorized by age range to accommodate different interests and maturity levels. You'll see there is an array of games and pictures for coloring, plus one-page handouts about fun dental apps and electronic games that can be shared with children and/or their parents. To learn more and see the electronic parts of the Toolkit, please visit the VHCF website. This toolkit was made possible by a grant from the Claude Moore Charitable Foundation.
New Profile of Virginia's Uninsured Now Available
Each year, the Virginia Health Care Foundation? The Profile provides a deep analysis of the most recent Census data about Virginia's uninsured, including regional rates of uninsurance, demographics, work status and much more. There are still 75,000 uninsured children under 200% FPL. These data may be useful as organizations work hard to reach those uninsured children who are eligible for coverage and remain unenrolled. To access the report visit http://www.vhcf.org/data/profile-of-the-uninsured/
Please Note:The Urban Institute report includes a special analysis that more accurately estimates the number of uninsured. The analysis done by The Urban Institute shows a higher number of uninsured in Virginia than may be reported by other sources.
FAMIS Program Enrollment as of June 1, 2016:
- 59,679 children were enrolled in FAMIS (including 120 in FAMIS Select)
- 522,316 children were enrolled in FAMIS Plus (including 51,625 in the CHIP Medicaid Expansion)
- 1,107 pregnant women were enrolled in FAMIS MOMS
- 16,842 pregnant women were enrolled in Medicaid for Pregnant Women
- 107,285 men and women were enrolled in Plan First
- 629 former foster care youth are enrolled in Medicaid