News

Federal Poverty Levels increased on January 20th for 2011 and the FAMIS Program Guidelines increased accordingly.

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.

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.


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:

  • Annual physical exams for men and gynecological exam for women (1 per 12 month period);

  • Cervical cancer screening for women (1 per 6 months);

  • Sexually transmitted infection testing;

  • Laboratory services for family planning and sexually transmitted infection testing;

  • Family planning education/counseling;

  • Sterilization procedures;

  • Food and Drug Administration (FDA) approved prescription contraceptives, including emergency contraception;

  • FDA approved over-the-counter contraceptives; and

  • 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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