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STATE CHILD HEALTH PLAN UNDER TITLE XXI OF THE SOCIAL SECURITY ACT

STATE: Virginia Page 2-6

Effective Date: 07/01/05

6 Approval Date: _____________/06 September 2002, the FAMIS program was revised again to provide for better coordination with the Medicaid program and to simplify the application process. FAMIS provides comprehensive health benefits for children from birth through age 18 who are not covered under health insurance and are not members of a family employed by a state agency or local government entity that contributes to the cost of dependent health care coverage. A mail-in application is used which addresses specific questions about other current and prior health insurance coverage A family may call a toll-free number and begin the application process. The FAMIS Central Processing Unit mails a preprinted Child Health Insurance application which can be completed, signed, and returned via mail or fax to the Central Processing Unit for Medicaid screening and FAMIS eligibility determination. If it appears the child is eligible for Medicaid, the application is forwarded to the outstationed Medicaid staff located at the Central Processing site or to the LDSS in the city or county where the family resides for Medicaid eligibility determination. Child Health Insurance applications may also be submitted to any LDSS for determination of eligibility of Medicaid and FAMIS. Expenditures for children who meet Medicaid eligibility criteria is claimed at the Commonwealth’s regular Medicaid FMAP. Effective 9/01/02, the Commonwealth began claiming enhanced funding for optional targeted low-income children who qualify under the Medicaid expansion. Expenditures for the children determined eligible under the Family Access to Medical Insurance Security Plan are claimed at the State’s enhanced FMAP.

No Entitlement: In accordance with § 2102(b)(4) of the Social Security Act (42 U.S.C. § 1397bb(b)(4)) and § 32.1-353 of the Code of Virginia, the Family Access to Medical Insurance Security Plan shall not create any individual entitlement for payment of medical services or any right or entitlement to participation.

2.2.2. The steps the state is currently taking to identify and enroll all uncovered children who are eligible to participate in health insurance programs that involve a public- private partnership:

Virginia currently has no health insurance programs that involve a public-private partnership.

2.3. Describe the procedures the state uses to accomplish coordination of SCHIP with other public and private health insurance programs, sources of health benefits coverage for children, and relevant child health programs, such as title V, that provide health care services for low-income children to increase the number of children with creditable health coverage. (Previously 4.4.5.) (Section 2102)(a)(3) and 2102(c)(2) and 2102(b)(3)(E)) (42CFR 457.80(c))