RD224 - Quarterly Report on the Activities of the Family Access to Medical Insurance Security (FAMIS) Plan (June 1, 2005 to September 30, 2005)


Executive Summary:
The Family Access to Medical Insurance Security (FAMIS) program is Virginia’s State Child Health Insurance program (SCHIP) for low-income children funded under Title XXI of the Social Security Act. This quarterly report conveys the status of the FAMIS program during the third quarter of calendar year 2005 – July, August and September 2005.

During the third quarter of 2005:

• Enrollment in Virginia’s SCHIP program (including the separate FAMIS program and the SCHIP Medicaid Expansion program) reached 74,521 representing a net increase of 1,334 children since the end of the previous quarter on June 30, 2005;

• Approximately 97% of children estimated to be eligible for FAMIS Plus (Medicaid) or FAMIS were enrolled, an increase of 1% from the end of the previous quarter;

• The FAMIS Central Processing Unit (CPU) received 44,712 calls, 12,280 applications and 3,303 FAMIS cases transferred from local departments of social services;

• 11,159 children were approved by the CPU and the Department of Social Services for FAMIS;

• Approximately 75% of enrolled children received FAMIS or Medicaid Expansion benefits through a Managed Care Organization (MCO);

• Total third quarter expenditures for medical services for children enrolled in Virginia’s Title XXI program were $33,638,882;

• On August 1, 2005, the FAMIS program was expanded to include coverage for pregnant women with income above the Medicaid limit and equal to or less than 150% of the Federal Poverty Limit. There were 79 women enrolled in the new FAMIS MOMS program as the quarter ended.

• Also, on August 1, 2005 the former premium assistance program available to FAMIS children with access to employer-sponsored health insurance was converted into the FAMIS "Select" program. FAMIS "Select" provides $100 per month per child in premium assistance, up to the total cost of the family’s monthly premium, if they choose to move their child out of FAMIS and into an employer-sponsored or private health plan.