CHIP State Plan and Waiver-Related Documents

FAMIS MOMS/Select and 12 Months Postpartum Demonstration

Virginia's FAMIS MOMS/Select and 12 Months Postpartum Demonstration is currently approved through June 30, 2029. Demonstration updates will be posted to this webpage.

Amendment

Demonstration Amendment - 12 Months Postpartum Coverage

On November 18, 2021, Virginia received approval from the federal Centers for Medicare and Medicaid Services (CMS) of its Section 1115 demonstration amendment to provide 12 months continuous postpartum coverage for Medicaid and FAMIS MOMS members. This change will improve continuity of coverage and access to care for Medicaid and CHIP-enrolled women during the critical postpartum period. Virginia applied for the amendment to extend postpartum coverage pursuant to a mandate in the 2020 Special Session I Virginia Acts of Assembly, Chapter 56. 

Approval documents, including the Special Terms and Conditions, are available here.

The amendment application, including public comments, is available here.

Evaluation

Demonstration Evaluation Updates

On November 3, 2021, the Centers for Medicare & Medicaid Services (CMS) approved Virginia's revised evaluation design for the FAMIS MOMS and FAMIS Select Section 1115 Demonstration. This approved evaluation design reflects the longstanding waiver components before the addition of the postpartum component. The evaluation design, along with the CMS approval letter, is available here.

CMS has also approved Virginia's evaluation design for the 12 months postpartum demonstration component. Through the postpartum demonstration, Virginia aims to reduce maternal and infant mortality and morbidity, improve health outcomes for mothers and infants, and address health disparities. View the postpartum evaluation design, along with the CMS approval letter.

FAMIS MOMS and FAMIS Select

FAMIS MOMS and FAMIS Select - CHIP Demonstration Populations

In addition to the newly approved 12 months postpartum coverage component, the Demonstration also authorizes two CHIP-funded programs that have been in place with periodic renewals since 2005. First, the Demonstration expands coverage to uninsured pregnant women with family income up to 205% of the federal poverty level (FPL) who are not eligible for Medicaid, through a program known as FAMIS MOMS. Pregnant women who are eligible for this coverage include those who are lawfully residing immigrants and those with access to state employee health benefit coverage.

Second, the Demonstration uses CHIP/Title XXI funds to support a health insurance premium assistance program known as FAMIS Select. FAMIS Select offers private or employer-sponsored insurance (ESI) premium assistance for families with children in FAMIS, Virginia’s CHIP program. Enrollment in FAMIS Select is voluntary, based on informed choice regarding the implications of choosing premium assistance in lieu of direct CHIP state plan coverage.

In October 2019, the FAMIS MOMS and FAMIS Select Title XXI Section 1115 Demonstration was renewed for a period of 10 years, through June 30, 2029. Access the approval documents, including Special Terms and Conditions for the renewal period. Access the final approved renewal application, including public comments.

Read the most recent Prenatal Care and Birth Outcomes Focused Study reports from DMAS’ External Quality Review Organization (EQRO). For more information about this Demonstration, please visit the Centers for Medicare and Medicaid Services (CMS) website.

Section 1115 of the Social Security Act gives the U.S. Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that promote the objectives of Medicaid and the Children’s Health Insurance Program (CHIP). Under this authority, the Secretary may waive certain provisions of Medicaid or CHIP to give states additional flexibility to design and improve their programs. To learn more about Section 1115 demonstrations, please visit the CMS website.