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Virginia FAMIS MOMS and FAMIS Select Section 1115 Demonstration Page 3 of 3 CMS Approved October 25, 2019 – June 30, 2029; amended November 18, 2021

To permit the Commonwealth to offer a benefit package that does not meet the requirements of section 2103 at 42 CFR section 457.4 10(b)(1) for the demonstration populations.

5. Federal Matching Payment and Family Coverage Limits Section 2105

Federal matching payment in excess of the 10-percent cap for expenditures related to the demonstration population and limits on family coverage are not applicable to the demonstration population.

Title XIX Expenditure Authority:

1. Expenditures for extending the postpartum eligibility period for pregnant and postpartum individuals enrolled in any Medicaid state plan eligibility group from the end of the month in which the 60th postpartum day occurs to the end of the 12th month following the end of the pregnancy. These expenditures are authorized for the “postpartum extension” component of the demonstration.

This expenditure authority is limited to a five-year period starting on April 1, 2022 through March 31, 2027 for Medicaid “lawfully residing” pregnant individuals as described in STC 17.

2. Expenditures for pregnant and postpartum individuals to be continuously eligible without regard to changes in circumstances through the end of the 12-month extended postpartum eligibility period as set forth in STC 17.

This expenditure authority is limited to a five-year period starting on April 1, 2022 through March 31, 2027 for Medicaid “lawfully residing” pregnant individuals as described in STC 17.