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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 January 2014 Subchapter Subject Page ending with Page M0310 GENERAL RULES & PROCEDURES M0310.135 39
B. State Plan Governs Medicaid Eligibility Rules The State Plan consists of preprinted material that covers the basic Medicaid requirements and individualized material written by DMAS that reflects the particular requirements and choices made by Virginia for its Medicaid program. The State Plan is included in DMAS’ state regulations promulgated according to the Virginia Administrative Process Act (APA). The State Plan is kept and updated by DMAS. The State Plan shows the eligibility requirements for Virginia Medicaid, including the mandatory and optional groups of individuals covered by Virginia Medicaid and the medical services covered by Medicaid for those groups. The covered groups eligibility requirements in this chapter are based on the State Plan.
M0310.132 TANF
A. Temporary Assistance for Needy Families (TANF) TANF is the federally-funded (with matching funds from the states) block grant program in Title IV Part A of the Social Security Act that provides temporary cash assistance to needy families. In Virginia, TANF replaced the previous Title IV-A program called Aid to Families With Dependent Children (AFDC) on February 1, 1997.
M0310.133 BCCPTA
A. Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA) The BCCPTA created a Medicaid covered group for women and men age 18 through 64 who have been identified by the Centers for Disease Control and Prevention's (CDC) Breast and Cervical Cancer Early Detection Program (BCCEDP) as being in need of treatment for breast or cervical cancer. B. Procedures Section M0330.700 contains the detailed requirements for the BCCPTA covered group.
M0310.134 VIEW PARTICIPANT
A. Virginia Initiative for Employment not Welfare (VIEW) Participants A VIEW participant is an individual who has signed the TANF Agreement of Personal Responsibility. For renewals completed and changes reported prior to April 1, 2014, VIEW participants have a higher earned income limit than non-VIEW participants. An individual under a TANF VIEW sanction is a VIEW participant for Medicaid purposes. An individual only receiving TANF transitional support services is not a VIEW participant for Medicaid purposes. Modified Adjusted Gross Income (MAGI) methodology does not differ between VIEW participants and other individuals.
M0310.135 HIPP PROGRAM
A. Health Insurance Premium Payment (HIPP) Program HIPP is a cost savings program administered by the DMAS for Medicaid enrollees which reimburses some or all of the employee portion of group health insurance premiums. HIPP is available to Medicaid enrollees when a family member is employed at least 30 hours per week and is enrolled in an employer’s group health plan. Eligibility for HIPP is determined by the HIPP Unit at DMAS. Participation in HIPP is voluntary. B. Procedures M0130.200 G contains additional information about HIPP.