Virginia’s pending application to amend the FAMIS MOMS and FAMIS Select CHIP Section 1115 Demonstration to provide 12 months postpartum coverage can be found here.
Updates on the status of Virginia's Demonstration amendment application will be posted to this webpage.
FAMIS MOMS and FAMIS Select
FAMIS MOMS and FAMIS Select CHIP Section 1115 Demonstration
Virginia’s CHIP Section 1115 Demonstration has two components. First, it expands coverage to uninsured pregnant women with family income up to 205% of the federal poverty level (FPL) who are not eligible for Medicaid, through a program known as FAMIS MOMS. Pregnant women who are eligible for this coverage include those who are lawfully residing immigrants and those with access to state employee health benefit coverage. Second, the Demonstration uses CHIP/Title XXI funds to support a health insurance premium assistance program known as FAMIS Select. FAMIS Select offers private or employer-sponsored insurance (ESI) premium assistance for families with children in FAMIS, Virginia’s CHIP program. Enrollment in FAMIS Select is voluntary, based on informed choice regarding the implications of choosing premium assistance in lieu of direct CHIP state plan coverage.
In November 2020, the FAMIS MOMS and FAMIS Select Title XXI Section 1115 Demonstration was renewed for a period of 10 years, through June 30, 2029. Approval documents, including Special Terms and Conditions for the renewal period, can be found here. The final approved renewal application, including public comments, can be found here.
To read the most recent Prenatal Care and Birth Outcomes Focused Study reports from DMAS’ External Quality Review Organization (EQRO), please follow this link. For more information about the FAMIS MOMS and FAMIS Select Demonstration, please visit the Centers for Medicare and Medicaid Services (CMS) website.
Demonstration Amendment – 12 Months Postpartum Coverage
On March 31, 2021, Virginia submitted an application to the federal government to amend the FAMIS MOMS and FAMIS Select CHIP 1115 Demonstration. The final amendment application is available here. This amendment was submitted pursuant to a state mandate in the 2020 Special Session I Virginia Acts of Assembly, Chapter 56, directing DMAS to seek federal approval to provide extended postpartum coverage.
With this amendment, Virginia proposes to extend health coverage from 60 days to 12 months postpartum for pregnant women with income below 205 percent of the FPL who are not eligible to transition to another coverage group postpartum. This change will improve continuity of coverage and access to care for Medicaid and CHIP-enrolled women during the critical postpartum period. Through this amendment to the Demonstration, Virginia aims to reduce maternal and infant mortality and morbidity, improve health outcomes for mothers and infants, and advance health equity.
The Commonwealth’s 31-day public comment period for the Demonstration amendment took place from February 19, 2021 through March 22, 2021, during which members of the public were invited to submit comments to DMAS by e-mail, voicemail, or via the electronic public forum on the Virginia Regulatory Town Hall website. In compliance with federal and state requirements, DMAS also provided notice to Virginia’s seven federally recognized Tribal governments in a notification letter sent January 29, 2021. The letter notified Tribal officials and Indian Health Program staff of the 60-day Tribal comment period for the Demonstration amendment and invited comment from Tribal members.
In addition, DMAS convened a public hearing, held at the quarterly CHIPAC meeting via Zoom on March 4, 2021 from 1:00 to 3:30 PM ET, during which members of the public were able to comment on the Demonstration amendment. The meeting was held virtually rather than in person due to state restrictions on public meetings during the COVID-19 public health emergency. The format of the public hearing included an overview of the proposed waiver amendment, followed by the collection of public comments submitted orally and through the public chat function in Zoom.
To read the full Public Notice for the FAMIS MOMS Demonstration Amendment – 12 Months Postpartum Coverage, please follow this link.
Summary of Public Comments Received
The overwhelming majority of commenters expressed support of the Demonstration amendment to extend coverage from 60 days to 12 months postpartum. Several comments posed questions without a stated opinion. None of the comments submitted were in opposition to the Demonstration amendment.
DMAS’ summary of and response to the comments received during the public and Tribal comment periods is in Section 7.1 of the final Demonstration amendment application. All written comments are included in Appendix B of the amendment application, and comments received during the virtual public hearing are memorialized in Section 7.2 – Exhibit G.
Section 1115 of the Social Security Act gives the U.S. Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that promote the objectives of Medicaid and the Children’s Health Insurance Program (CHIP). Under this authority, the Secretary may waive certain provisions of Medicaid or CHIP to give states additional flexibility to design and improve their programs. To learn more about Section 1115 demonstrations, please visit the CMS website at https://www.medicaid.gov/medicaid/section-1115-demo/index.html.