Virginia lands millions for children's insurance

Virginia received a bonus of almost $20 million Wednesday from the Centers for Medicare & Medicaid Services for its success in improving access to insurance for low-income children under the CHIP and Medicaid programs. The 2012 performance bonus was part of more than $305 million handed out to 23 states under the 2009 Children's Health Insurance Program Reauthorization Act.

This is the second year of the four years the bonuses have been available that Virginia has snagged one. The bonus helps offset the added cost of insuring the lowest income children and encourages the ongoing elimination of barriers to gaining insurance. States receiving the bonuses must meet five of eight qualifying features. These include eliminating face-to-face interview requirements and allowing online applications, and using an electronic database for renewals to help maintain coverage for children throughout their eligibility. In Virginia, that eligibility is set at 200 percent of the federal poverty level, or an income of $46,100 for a family of four. Most states use the more generous cut-off of 240 percent of the FPL, according to Cindy Mann, director of the Center for Medicaid and CHIP Services.

States must also beat a target improvement in enrollment. Virginia received a boost in its bonus by increasing its enrollment by more than 10 percent to reach Tier 2 status. According to the Department of Medical Assistance Services, which oversees the programs, it enrolled 62,339 children statewide last year.

The CHIP program was established in 1997 to expand coverage to children in need who don't qualify for Medicaid. In Virginia it is known as FAMIS, or Family Access to Medical Insurance. "By providing preventive services, and medical care when necessary, it provides security to parents," said Mann, in a conference call. She noted a resulting significant decline in the rate of uninsured children as compared to the number of adults. The Urban Institute reports that 86 percent of eligible children are covered nationally; in Virginia 86.2 percent are covered. CHIP covers well baby visits, vaccinations, prescriptions, dental care, tests and X-rays, vision care and mental health care. Some services require a co-pay of between $2 and $5, but preventive care and well visits are free.

Twenty two of the 23 states receiving the bonuses were repeat recipients. "We want to see the simplifications and enrollment gains over time. "We don't want one-shot actions," said Mann. The bonuses are designed with a dual purpose of encouraging states to adopt sustainable improvements and providing dollars to offset the costs.

To check your child's eligibility, call 1-877-543-7669.

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