Medicaid, SCHIP, and Federal Authority²

Section 1115/HIFA Waiver - In June 2005, Virginia received approval from CMS for a demonstration waiver entitled FAMIS MOMS and FAMIS Select. The waiver allows the state to claim Title XXI funding for pregnant women above 133 percent FPL through 200 percent FPL. Phase I will cover pregnant women with incomes above 133 percent FPL through 150 percent FPL and Phase II will cover pregnant women with incomes above 150 percent FPL through 200 percent FPL. The expansion is subject to the availability of state funds. The waiver also includes a premium assistance option, called FAMIS Select, for children under 200 percent FPL. Families who choose to enroll in FAMIS Select can get up to $100 per FAMIS Select enrolled child per month to help pay their family premium.

Group Purchasing Arrangements

On July 1, 2006, small businesses that employ 2- 50 employees will be able to join together to form purchasing cooperatives.  These cooperatives will be able to purchase or facilitate providing insurance to employees (and dependents of employees) who work more than 30 hours per week.  The legislation authorizes the cooperatives to negotiate premiums for their members.  Regulatory guidance has not been issues by the state Insurance Commission.  Full text for H.B. 761 is available online.

Other

Indigent Health Care Trust Fund - The Virginia General Assembly created the Indigent Health Care Trust Fund in 1989 as a public-private partnership involving the state government and private acute care hospitals. The purpose of the fund is to help offset some of the charity care provided by Virginia 's private acute care hospitals. The fund reimburses hospitals for the cost of charity care provided to any person whose annual family income is equal or less than 100 percent FPL.

State and Local Hospitalization Program (SLH) - SLH provides funding for hospital costs incurred by indigent persons. It differs from the Trust Fund because while the Trust Fund reimburses hospitals based upon an overall amount of charity care provided by each hospital, the SLH program is "claims-based" - specific claims incurred by eligible indigent persons are approved for payment. SLH assistance is available to persons who are not enrolled in Medicaid and have incomes at or below 100 percent FPL.

	Notes and Sources

Information presented in the profile was summarized in December 2006 from a review of state Web sites and reports, and through contacts with state officials. In most cases the profiles were reviewed by state officials; however, it is possible that states have implemented strategies that are not reflected in this profile.