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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 October 2025 Subchapter Subject Page ending with Page M0310 GENERAL RULES & PROCEDURES M0310.116 30a

A child who is eligible for IV-E Foster Care but who does not receive a IV-E Foster Care maintenance payment is considered a “Non-IV-E Foster Care” child for Medicaid eligibility purposes. Children in the custody of another state’s social services agency, who are eligible for and receive Title IV-E Foster Care maintenance payments and who now reside in Virginia, are IV-E Foster Care for Medicaid eligibility purposes. Verify the child’s IV-E eligibility from the other state’s department of social services which makes the IV-E payment. 2. Non IV-E Foster Care Children who are eligible for but do not receive IV-E maintenance payments or who are eligible for Non-IV-E (state/local) Foster Care (whether or not they receive a Non-IV-E payment), and who reside in Virginia are Non-IV-E Foster Care for Medicaid eligibility purposes.

3. Non-IV-E Children in Another State’s Custody A child in the custody of another state’s social services agency who is not receiving IV-E foster care maintenance or SSI payments, does NOT meet the Virginia residency requirement for Medicaid (M0230) and is not eligible for Virginia Medicaid UNLESS the child has been placed with and is residing in Virginia with a parent or care-taker relative. 4. Trial Home Visits A foster care or DJJ child continues to meet the foster care definition (either IV-E or non-IV-E) when placed by the agency in the child’s own home for a trial period, if the child continues to be in the agency’s custody or remains the financial responsibility of DJJ or the court. If a Medicaid renewal is due during the trial home visit, continue to treat the child as a foster care or DJJ child.

M0310.116 HOSPICE

A. Definition "Hospice" is a covered group of terminally ill individuals whose life expectancy is 6 months or less and who have voluntarily elected to receive hospice care. The term “hospice” is also used to refer to the covered service for a terminally ill Medicaid recipient, regardless of his covered group. Hospice services can be provided in the individual’s home or in a medical facility, including a nursing facility. 1. Hospice Care "Hospice care" means items and services are provided to a terminally ill individual by, or by others under arrangements made by, a hospice program under a written plan of care for the individual that is established and periodically reviewed by the individual's attending physician and the hospice program's medical director: 2. Hospice Program A "hospice program" is a public agency or private organization which • is primarily engaged in providing hospice care, makes hospice care services available as needed on a 24-hour basis, and provides bereavement counseling for the terminally ill individual's immediate family; • provides hospice care in individuals' homes or in medical facilities on a short-term inpatient basis; • meets federal and state staffing, record-keeping and licensing requirements.