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News
Federal Poverty Levels increased on January
20th for 2011 and the
FAMIS Program Guidelines increased accordingly.
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Online Application Improvements
Forty-five percent (45%) of all new applications coming to
the CPU are submitted on line. This process currently
involves a family completing the online questionnaire,
printing out a signature page, signing it, and faxing or
mailing that page and any needed verifications to the CPU
for processing. The application is not considered “valid”
and the clock does not start ticking on eligibility, until
the CPU receives the signature page. On July 15, 2010,
that will change when the Commonwealth implements its
electronic signature process. With this, immediately upon
completing the online questionnaire, the family will be
able to “sign” the application and it will start pending
for eligibility at the CPU. Additionally, the CPU is in
the design and approval process for a method of accepting
verification documents as electronic attachments to the
application.
Renewal Process Changes for FAMIS
On June 15th, the FAMIS CPU began utilizing a
single-page (2-sided) renewal form for FAMIS renewals. The
CPU has streamlined the processes and is sending families
of children due for renewal a single page renewal form
pre-populated with case information. Parents review it,
make any needed changes, and return the form to the CPU to
renew coverage in the FAMIS program.
Additionally, the CPU will be making online
renewal of FAMIS eligibility available to families.
Effective July 15, 2010, enrollees will receive an Access
Code which they will use along with their Family ID Number
to access their prefilled single page renewal application
online via the FAMIS website. The family will be able to
review the renewal document, make any needed changes, and
submit it electronically for processing.
Deeming of Babies Born to FAMIS MOMS and FAMIS
Enrollees
No longer will a woman enrolled in FAMIS MOMS have to file
an application to get her newborn enrolled in FAMIS. As of
July 1, 2010, she will be able to call the FAMIS CPU and
report the birth of her baby (giving the CPU the date of
birth and the baby’s name, sex, and race). The CPU will
deem the baby eligible for FAMIS and enroll it for a year.
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Federal Poverty
Guidelines Hold at 2009 Levels (8/3/2010)
The
federal poverty levels for the remainder of 2010 have just
been released and effect no changes from the 2009 FPLs. The
notice is available at
http://aspe.hhs.gov/poverty/index.shtml.The federal
register notice, published today, is available at
http://edocket.access.gpo.gov/2010/pdf/2010-19129.pdf.
As you may recall, recent
legislation prohibited publication of 2010 poverty
guidelines before May 31, 2010, and required that the 2009
poverty guidelines remain in effect until publication of
updated guidelines. There was concern that the way the
levels are calculated would raise the poverty levels and
leave many ineligible for federal programs which use the
poverty levels as a basis of income eligibility.
Legislation to further delay publication of the 2010
guidelines was not enacted. As noted by the Assistant
Secretary for Planning and Evaluation (ASPE, the part of
HHS tasked with setting the FPLs), the procedure for
updating the 2010 guidelines was modified to take into
account the Consumer Price Index (CPI-U) for the period
for which their publication was delayed. As a result, the
poverty guideline figures for the remainder of 2010 showed
no change from the 2009 poverty guideline figures.
(Source: National Health
Law Program)
Citizenship and
Identity Documentation Now Required for FAMIS and FAMIS
MOMS
As of January 1, 2010, families applying for the FAMIS and
FAMIS MOMS programs that indicate US Citizenship for an
applicant on the Application for Health Insurance for
Children and Pregnant Women are now required to
provide proof of Citizenship and Identity (C&I) for those
applicants as a condition of eligibility. This requirement
came about as a result of federal CHIPRA legislation
passed in early 2009. Providing proof of C&I has been part
of the FAMIS Plus and Medicaid for Pregnant Women programs
since 2007, so this change actually makes the requirement
consistent for all people applying on the Application.
The easiest ways for
applicants to comply with the requirement to document C&I
is to provide their Social Security Number on the
Application. If they do, the Virginia Department of
Medical Assistance Services can check with the Social
Security Administration (SSA) and verify C&I
electronically via data match. If the information sent by
DMAS does not match SSA records, an applicant will have 90
days to provide written documentation of C&I (most
commonly a passport or both a birth certificate and
driver's license for those over the age of 16).
FAMIS MOMS Income
Guidelines Rise (7/09)
On July 1, 2009, the Virginia Department of Medical
Assistance services raised the income guidelines on the
FAMIS MOMS program from 185% FPL to 200% FPL. The
new income guidelines can be seen
here.
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New Family Planning Program - Plan First
Plan First,
Virginia’s new family planning program began January 1,
2008. The program is open to men and women who earn less
than or equal to 133% of the federal poverty level (FPL) –
or $1,132 monthly income for an individual. Individuals
who have comprehensive health care coverage or have had a
sterilization procedure are excluded from this program.
What is covered?
Plan First will
only cover family planning services and supplies. Covered
services include:
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Annual physical exams for men and
gynecological exam for women (1 per 12 month period);
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Cervical cancer screening for women (1
per 6 months);
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Sexually transmitted infection
testing;
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Laboratory services for family
planning and sexually transmitted infection testing;
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Family planning education/counseling;
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Sterilization procedures;
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Food and Drug Administration (FDA)
approved prescription contraceptives, including
emergency contraception;
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FDA approved over-the-counter
contraceptives; and
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Referrals to a PCP who may provide
care for free or on a sliding fee scale for services
not covered through Plan First.
How do you enroll?
An individual who meets the enrollment criteria can
enroll in the program using the Plan First
application. The completed application can be mailed,
dropped off or faxed to the local Department of Social
Services (DSS) in the city/county in which the applicant
resides. Applications are available online at
www.dmas.virginia.gov or at local DSS offices and
Health Departments.
Because of requirements from the Centers
for Medicaid and Medicare Services (CMS), women who are
covered through Medicaid for Pregnant Women will need to
complete the application for Plan First after the
baby is delivered to participate in this program. While
these women are still eligible for family planning
services, they will need to actively complete the
application in order to be enrolled in Plan First.
Women who are currently enrolled in the
Family Planning Waiver Services have received a letter
informing them of the changes to this program. These women
do not need to take action and will continue to receive
family planning benefits through Plan First.
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