COVID-19 Vaccine: Virginia is in Phase 2
Effective April 18th, everyone, age 16 and older, who lives in Virginia is now eligible to get the COVID-19 vaccine. For patients, friends or family that are looking for a vaccine nearby, you can help find a vaccine location here. For TPC users outside of Virginia, check your state health department website for more information on vaccine access & availability.
We Want to Hear from You - Annual Survey Coming in June
Please be on the lookout for our annual online survey coming this June! Your feedback is very important as we use your responses to help us plan and consider future software and program enhancements. We are always looking for ways we can provide you with
additional information to better help your patients with access to the medications and supplies they need.
Highlights of Important PAP Updates & Resources
CHECK OUT SOME OF THE NEW MEDS NOW AVAILABLE IN TPC!

  • Verquvo (used to treat chronic heart failure)
  • Evkeeza (used along with other low-density lipoprotein (LDL) lowering medicines in people older than 12 years of age with a type of high cholesterol)
  • Pepaxto (used for patients with multiple myeloma)
  • Ponvory (used for Multiple Sclerosis)
  • Fotivda (used to treat adults with advanced kidney cancer)
  • Qelbree (used to treat attention-deficit/hyperactivity disorder (ADHD) in children ages 6 to 17)
  • Lupkynis (used to treat lupus nephritis)

Merck’s PAP is spinning off select products to a new company, Organon, in June 2021. Applications for Maxalt, Nasonex, Vytorin, Zetia and Propecia that were approved by Merck prior to 12/31/20 will continue to honor refill requests until inventory is depleted or June 1. Applications that were processed by 3/31/21 for Asmanex, Dulera and Singulair Granules will also have refill requests fulfilled as long as reorders are completed by 5/31/21. It is not yet known if Organon will continue with a PAP for these medications. Staff continues to check in regularly with representatives at Merck and we will provide an update as soon as more information becomes available. A list of possible alternatives available on other PAPs has been distributed through email.

Pfizer RxPathways Patient Assistance Program has distributed a notice to providers that Premarin is no longer available until further notice. Providers will be notified by fax when this product becomes available for future reorders. Providers should speak with their patients about alternative therapy during this time.

Be sure to check out the Program Changes in TPC for additional updates as well as the mobile medication app to check for new medications!
Mark Your Calendars for Upcoming
TPC Virtual Trainings & Monthly Support Calls
Sign up for an online TPC training session if you are new to your organization and need to learn the basics. If you currently use TPC and are looking to refresh your skills or want to learn about additional advanced features, sign up for Advanced Training. To continue our support, we also host monthly calls where we provide updates and give users the opportunity for a Q & A session. It’s also a great opportunity to brainstorm and learn from other TPC users. Registration is not required to participate in the monthly calls. Zoom details are emailed out the week before and the week of the calls to current users. All sessions are Eastern Standard Time. Be sure to check the website for additional dates!

TPC Beginner Training
May 11, 2021 (10am-12pm)
June 9, 2021 (9:30am-11:30am)

TPC Advanced Training
June 1, 2021 (10am-12pm)

Monthly Support Calls (10 – 11am)
May 19, 2021
June 16, 2021

Check out some of the most frequently asked technical support Q & A!
Special Alert! Virginia Policy Changes Expand
Medicaid Eligibility and Services!
NEW! Rules Change Make More Individuals Eligible for Medicaid and Provide More Coverage

  • As of April 1st, adults who are Lawful Permanent Residents (LPRs, sometimes called “green-card holders”) are no longer be required to have 40 qualifying quarters of work in order to be eligible for Medicaid! 

  • The “40-Quarter Rule” has prevented many otherwise-eligible LPR adults from being able to enroll in Medicaid, even if they meet all other eligibility requirements (including having been lawfully present in the U.S. for 5 years or longer).

  • Individuals who may become eligible due to this change should be encouraged to apply or re-apply, so that their eligibility can be re-determined.

Check out this factsheet for details about this exciting change! Learn more at coverva.org.

  • Comprehensive Dental Benefit for Adults: Beginning July 1, 2021, Virginia’s Medicaid program will provide comprehensive dental benefits for adults! Dental coverage for adults enrolled in Medicaid will focus on overall oral health, prevention, and restoration. Services will include:
  • X-rays and examinations
  • Cleanings
  • Fillings
  • Root canals
  • Gum-related treatment
  • Dentures
  • Tooth extractions and other oral surgeries
  • Other appropriate general services, such as anesthesia.

Click here for resources for patients and providers regarding the benefit. https://vahealthcatalyst.org/adultdentalbenefit/. You can also click here to search for a dental safety net clinic in Virginia that accepts Medicaid.

  • Benefit on the Way for Pregnant Women: A new FAMIS prenatal benefit is on the way for income-eligible pregnant women living in Virginia, regardless of their immigration status.

  • Virginia’s General Assembly voted to make this new coverage available to women in households with incomes at or below 205% of the Federal Poverty Level (FPL), even if they do not meet the current lawfully residing immigration status requirement for pregnant women. Once the Governor officially approves the state budget, Virginia will apply to the Federal government to make this change. Federal approval is expected this year, with implementation as soon as July 1.

  • Extension of Postpartum Coverage for New Moms: Soon, women enrolled in FAMIS MOMS or Medicaid for Pregnant Women (MPW) will remain covered for one full year postpartum! Currently, women in these programs are covered only for the duration of their pregnancy, and 60 days postpartum. For women who currently do not qualify to transfer to another Medicaid coverage group, extending postpartum coverage to the 12-month mark will enable them to receive essential services aimed at helping mothers and their newborns stay healthy.

  • Virginia is applying to the federal government to make this change. The extension is expected to be implemented sometime in 2022.

  • Health Insurance Marketplace Reopened until August 15, 2021: Virginians who need health insurance, but who are above the income limits for Medicaid/FAMIS coverage, have another chance to purchase 2021 coverage through the Health Insurance Marketplace until August 15, 2021. And, as a result of certain provisions in the American Rescue Plan Act (ARPA), more Virginians than ever can receive financial help to purchase a plan!

  • Virginians can apply for health insurance through the Marketplace on their own at www.healthcare.govThose who need help understanding available coverage options, or applying for Marketplace coverage can obtain it by contacting a local Navigator or Certified Application Counselor (CAC), who is specially-trained to help Virginians weigh their options on the Marketplace. Visit coverva.org/findhelp to find the one closest to you.

Don’t forget - Virginians can apply for Medicaid or FAMIS year-round.
New Data on Virginia’s Uninsured!
Looking for data to help you focus your work to reach uninsured Virginians?

The 2021 Profile of Virginia’s Uninsured is available now on VHCF’s website. The Profile provides a wealth of information about uninsured Virginians, including:
  • Estimates of their number, percentage and demographics
  • Separate analyses of uninsured children and adults
  • Estimates of access to care
  • Tables highlighting key information about the uninsured who are income-eligible for Medicaid/FAMIS and the Marketplace, including demographics and regional estimates
  • Maps profiling key subpopulations

This is our first glimpse at the impact of Medicaid expansion (effective January 1, 2019) on reducing the number of uninsured in Virginia.

Note: The report shows an incremental increase in Virginians enrolled in health insurance over the course of the year, rather than the total number enrolled at the end of 2019, due to the methods used to collect data.

Questions? Please contact Denise Daly Konrad, VHCF’s Director of Strategic Initiatives (dkonrad@vhcf.org).