RD72 - Quarterly report on the activities of the Family Access to Medical Insurance Security (FAMIS) Plan (October 1, 2004 to December 31, 2004)


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 fourth quarter of calendar year 2004 – October, November and December 2004.

During the fourth quarter of 2004:

• Enrollment in Virginia’s SCHIP program (including the separate FAMIS program and the SCHIP Medicaid Expansion program) reached 68,524 representing a net increase of 4,810 children since the end of the previous quarter on September 30, 2004;

• Approximately 93% of children estimated to be eligible for FAMIS Plus (Medicaid) or FAMIS were enrolled, an increase of 3% from the end of the previous quarter;

• The FAMIS Central Processing Unit (CPU) received 38,281 calls, 9,026 applications and 3,024 FAMIS cases transferred from local departments of social services;

• 10,943 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 fourth quarter expenditures for medical services for children enrolled in Virginia’s Child Health Insurance Program were $26,960,712, and administrative expenditures totaled $915,512.

Appendix I provides updates on the Department’s implementation of the Joint Legislative and Audit Review Commission’s (JLARC) January 2002 recommendations for improving the Child Health Insurance Program in Virginia. Appendices II, III and IV provide a summary of the program changes mandated by the 2002, 2003 and 2004 sessions of the Virginia General Assembly and the resulting impact on enrollment.