RD78 - Quarterly Report on the Activities of the Family Access to Medical Insurance Security (FAMIS) Plan (October 1, 2005 – December 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 fourth quarter of calendar year 2005 – October, November and December 2005.

During the fourth quarter of 2005:

• Enrollment in Virginia’s SCHIP program (including the separate FAMIS program and the SCHIP Medicaid Expansion program) reached 76,517 representing a net increase of 1,996 children since the end of the previous quarter on September 30, 2005;

• From January 1, 2004 to January 1, 2005, the SCHIP program grew from 69,434 to 76,517 for a net increase of 7,083 (10.2%) enrolled children.

• Approximately 98% 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 46,512 calls this quarter with an average abandonment rate of 3%. The year-end total of calls received was 168,811.

• During the fourth quarter, 11,841 applications were received at the FAMIS CPU and 3,430 FAMIS cases were transferred from local departments of social services. Year end totals for 2005 were 44,376 applications received and 13,175 DSS cases enrolled;

• The FAMIS MOMS program for pregnant women was implemented on August 1, 2005 and 511 applications were received during this quarter;

• The e-application was introduced online February 1, 2005 and was modified to include pregnant women on August 1, 2005. During this quarter, e-applications accounted for 19% of all applications for children and 38% of all applications by pregnant women; The e-application was made available in Spanish on the FAMIS website in January 2006;

• In the fourth quarter, 11,668 children and 104 pregnant women were approved or renewed by the CPU and local Departments of Social Services for FAMIS and FAMIS MOMS respectively;

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

• Fourth quarter expenditures for medical services for children in Virginia’s SCHIP program were $31,875,494, an increase of $2,113,590 from the previous quarter. 2005 SCHIP expenditures totaled $126,609,534 (93.5% medical & 6.5% administration).

• The revamped Premium Assistance program, FAMIS Select, ended the quarter with 144 children enrolled in this voluntary program. This represents a significant increase over the highest number of participants (100) ever enrolled in the former E.S.H.I. program.