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Virginia FAMIS MOMS and FAMIS Select Section 1115 Demonstration Demonstration Period: October 25, 2019 through June 30, 2029; Amended November 18, 2021 Page 4 of 61 family based on verified payroll withholding amounts; with the maximum subsidy not to exceed a family’s total share of the total monthly premium.

Parents that choose FAMIS Select are responsible for all cost-sharing associated with the private or employer-sponsored plan. Virginia does not wrap benefits with the exception of immunizations if the family’s chosen plan does not provide such coverage.

The title XXI goals and objectives of the FAMIS Select program is as follows:

• Facilitate access to affordable private and employer-sponsored health insurance for low- income families through premium assistance; • Monitor and ensure member satisfaction with the FAMIS Select program; and, • Assure the aggregate cost-effectiveness of the FAMIS Select program.

Postpartum Extension for FAMIS MOMS and Medicaid State Plan Pregnant Individuals On November 18, 2020, Virginia Governor Ralph Northam signed into law the 2020 Special Session I Virginia Acts of Assembly, Chapter 56, directing the Department of Medical Assistance Services (DMAS) to seek federal approval to cover pregnant individuals for up to 12‐ months postpartum. Accordingly, Virginia submitted this section 1115 amendment request on March 31, 2021, and following the effective date of these STCs and an operational ramp-up period, will begin to implement the extension of postpartum coverage to provide a full 12-month period following the end of pregnancy. The 12-month postpartum period will be implemented statewide and made available to pregnant and postpartum individuals as detailed in STC 17.

This program component will support the demonstration’s goal of facilitating access to prenatal, obstetric, and postpartum care, particularly for those in the Commonwealth facing the highest rates of maternal and infant mortality and morbidity. This amendment is expected to improve continuity of coverage and access to care for Medicaid and CHIP enrolled individuals during the postpartum period and will be evaluated on whether 12‐months postpartum coverage reduces maternal and infant mortality and morbidity, improves health outcomes for both the mother and the infant, and advances health equity.

III. GENERAL PROGRAM REQUIREMENTS

1. Compliance with Federal Non-Discrimination Statutes. The Commonwealth must comply with applicable federal statutes relating to non-discrimination. These include, but are not limited to, the Americans with Disabilities Act of 1990 (ADA), Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973 (Section 504), the Age Discrimination Act of 1975, and Section 1557 of the Affordable Care Act (Section 1557).

2. Compliance with Medicaid and CHIP Law, Regulation, and Policy. All requirements of Medicaid and CHIP expressed in law, regulation, and policy statement, not expressly waived or identified as not applicable in the waiver and expenditure authority documents (of which these terms and conditions are part), must apply to the demonstration.