RD84 - Quarterly report on the activities of the Family Access to Medical Insurance Security (FAMIS) Plan (January 1, 2005 – March 31, 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 first quarter of calendar year 2005 – January, February and March 2005.

During the first quarter of 2005:

• Enrollment in Virginia’s SCHIP program (including the separate FAMIS program and the SCHIP Medicaid Expansion program) reached 70,861 representing a net increase of 2,337 children since the end of the previous quarter on December 31, 2004;

• Approximately 95% of children estimated to be eligible for FAMIS Plus (Medicaid) or FAMIS were enrolled, an increase of 2% from the end of the previous quarter;

• On February 18, 2005, the Department of Health and Human Services issued new Federal Poverty Limits (FPL) and these new income limits were immediately implemented for the FAMIS program;

• On February 1, 2005, a new on-line application was initiated on the FAMIS web site. In the first two months (February and March), 1,088 unduplicated applications were submitted electronically;

• The Department of Medical Assistance Services (DMAS) and the Virginia Department of Health (VDH) collaborated to enhance the web-based intake system currently utilized by VDH to automatically pre-fill a FAMIS/FAMIS Plus application for uninsured children. Six health districts began pilot testing the new system in preparation for statewide implementation;

• The FAMIS Central Processing Unit (CPU) received 39,251 calls, 9,688 applications and 2,715 FAMIS cases transferred from local departments of social services;

• 11,067 children were approved by the CPU and the Department of Social Services for FAMIS;

• Approximately 74% of enrolled children received FAMIS or Medicaid Expansion benefits through a Managed Care Organization (MCO);

• Total first quarter expenditures for medical services for children enrolled in Virginia’s Title XXI program were $27,331,750, and administrative expenditures totaled $1,176,057 or 4% of total expenditures; and

• DMAS began program planning to implement an expansion of the FAMIS program to cover pregnant women with income up to 150% FPL and to modify the SCHIP premium assistance program as authorized by the 2005 General Assembly.