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This newsletter is made possible with support of the
In This Issue:
- DMAS Adds Addiction and Recovery Treatment Services (ARTS)
- New, Coordinated Benefit Delivery System Coming This Summer
- Smiles For Children Celebrates Two Years of Dental Benefits for Pregnant Women
- Coverage for Graduates of the FAMIS Programs: Plan First
- Tips & Resources for Helping Families
- *NEW* SignUpNow Training Coming in April!
- Marketplace Updates
- FAMIS Programs Enrollment Updates
DMAS Adds Addiction and Recovery Treatment Services (ARTS)
Many people struggle with using addictive substances at some time in their lives. There is good news though! Most people with a substance use disorder can benefit from treatment no matter how bad the problem may be.
Effective April 1, 2017, DMAS will implement a new substance use disorder treatment benefit: Addiction and Recovery Treatment Services (ARTS)! These services will be covered for any Medicaid enrollees in Managed Care Organizations (MCOs), Commonwealth Coordinated Care (Medicare/Medicaid Plans) and fee-for-service (through Magellan). ARTS also expands certain services to adults enrolled in Medicaid including inpatient withdrawal management (detoxification) and residential services. There are a range of treatments that each plan covers for all members.
New, Coordinated Benefit Delivery System Coming This Summer
A new, coordinated benefit delivery system for individuals with complex care needs is coming to Virginia this summer. The Commonwealth Coordinated Care Plus ("CCC Plus") program will emphasize integrated and value-based care, and will serve approximately 214,000 individuals, including kids with disabilities and complex needs.
DMAS will roll out the program by region, beginning with Tidewater, on August 1. Find more information about CCC Plus here.
Smiles For Children Celebrates Two Years of Pregnant Women's Dental Benefits
Effective March 1, 2015, all pregnant women enrolled in state-sponsored health insurance became eligible for expanded dental benefits through the Smiles For Children program. While oral health is a vital part of overall health for everyone, this is especially true for pregnant women.
During pregnancy, it's critical for a woman to take care of her teeth, eat a variety of healthy foods, and avoid using tobacco or alcohol. Good oral health helps to ensure overall health for both mom and baby. Here are three important facts about pregnancy and oral health to share with your families:
- Oral care is SAFE during pregnancy. It's important for pregnant women to visit a dentist every six months or any time there is a concern.
- Changes to the body during pregnancy can cause gums to become sore and swollen and possibly to bleed. This is called gingivitis and should be treated by a dentist.
- Brushing at least twice a day, replacing toothbrushes every 3-4 months, and rinsing every night with a mouthwash that contains fluoride helps keep bacteria at bay.
Coverage for Graduates of the FAMIS Programs: Plan First
Have you heard about Plan First? This limited-benefit program provides coverage for family planning services for both men and women with incomes up to 205% of the Federal Poverty Level (FPL).
Remind eligible parents and graduates of the FAMIS programs to contact their eligibility worker so that they can be evaluated for coverage, and encourage enrollees and potential enrollees to use their Plan First benefits for:
- Contraceptives
- Sexually-Transmitted Infection (STI) testing
- Family Planning education and counseling
- Pap tests
For a more comprehensive list of what's covered, or to learn more about Plan First, check out www.PlanFirst.org or contact [email protected].
Tips and Resources for Helping Families
NEW Eligibility Limits Mean More Families Qualify for the FAMIS Programs
On January 31, 2017, the U.S. Department of Health & Human Services released the 2017 Federal Poverty Level tables. The Federal Poverty Level (FPL, for short) increases slightly each year to account for inflation, thus allowing more families to qualify for the FAMIS programs. Now, a family of four making $50,430 or less can qualify for the FAMIS programs! To view the updated income guidelines, click here.
Coming Soon - Virginia DSS Enterprise Customer Service Center
In April 2017, the Virginia Department of Social Services will open a call center that will allow families to apply for multiple benefits by phone, similar to the way they can apply for multiple benefit programs online through CommonHelp.
The call center, known as the Enterprise Customer Service Center (CSC), will accept applications and questions regarding Temporary Assistance for Needy Families (TANF), the Supplemental Nutrition Assistance Program (SNAP), and Medical Assistance, including the FAMIS Programs. Applications received by the Enterprise CSC will be routed to local Departments of Social Services for an eligibility determination. Families seeking only to apply for or get information about Medical Assistance, including the FAMIS Programs, will be transferred to Cover Virginia.
The Enterprise CSC will be able to give callers information about:
- The status of a family's application and whether a case is active or inactive
- The amount of benefits authorized (for SNAP and TANF)
- The date benefits were issued and the date of renewal
- How to file an appeal
The Enterprise CSC will not accept renewals initially, but will assist with questions regarding cases and enforcement actions for the Division of Child Support Enforcement and the Division of Child Care & Early Childhood Development.
Quick Tip: Following Up on Submitted Applications
If you are assisting a pregnant woman who applied 8+ days ago or another applicant who applied 15+ days ago and has not received any contact from the local DSS caseworker, you can call the local agency and receive the name of the worker processing the applicant's case. From there, you can submit verification documents via fax by sending them to the attention of "Appropriate Worker."
New SignUpNow Training Coming in April!
Beginning in April, the Virginia Health Care Foundation will present its new, 2017 edition of
SignUpNow! This year's updated
SignUpNow will include information about the full continuum of coverage available to Virginia families, so be sure to attend even if you've done so in the past. Registration is live...so sign up NOW!
Marketplace Updates
Virginia Emerges as a Leader as Open Enrollment Period Closes
January 31, 2017 saw the closure of the fourth Open Enrollment Period for the Federally Facilitated Marketplace (FFM, or "Marketplace"). The Marketplace provides a place for families to shop for quality, affordable health insurance coverage. A recent estimate from the Centers for Medicare and Medicaid Services puts Virginia at having the 6th highest enrollment of the 38 states using the FFM, with more than 410,700 individuals enrolling in coverage during the Open Enrollment Period.
Many parents whose children qualify for the FAMIS Programs are eligible for coverage through the Marketplace. Don't forget: the FAMIS Programs are open for enrollment year-round!
Federal Marketplace Backlog Causes Application Delays
Due to an abundance of applications transferred from the Marketplace to the local Departments of Social Services (
LDSS) and Cover Virginia during the recent Open Enrollment Period, applications submitted during the months of November, December, and early January may experience delays in processing time.
To help speed things along, any "Medical Benefits Only" applications submitted online via CommonHelp on or after January 9 will be processed at local agencies rather than the Cover Virginia Central Processing Unit. All applications submitted via CommonHelp or through the Cover Virginia Call Center should have a T-number assigned. Clients and enrollment assisters can use the T-number to track the status of an application with the LDSS or Cover Virginia.
Medicaid & FAMIS Enrollment Updates
As of March 1, 2017, there were...
113,571 children enrolled in FAMIS, including 52,890 in the CHIP Medicaid Expansion;
487,557 children enrolled in FAMIS Plus;
1,128 pregnant women enrolled in FAMIS MOMS; and
15,624 pregnant women enrolled in Medicaid for Pregnant Women
 DMAS Adds Addiction and Recovery Treatment Services (ARTS), cntd.
- The first step is for the member to talk with his/her primary care doctor. Ask for more details about treating substance or alcohol problems.
- Treatment options are available. They range from outpatient to inpatient care. This includes Medication Assisted Treatment. This option is used for individuals who struggle with the use of prescription drugs or other opiates. The individual's doctor and/or health care team will work to find the best program to help.
- Each MCO/CCC plan and Magellan have a dedicated ARTS Care Coordinator. They are available to 24/7. Please call the nurse hotline for the specific MCO/CCC plan or Magellan. These calls are confidential.
Beginning in July, peer supports will also be covered for all enrollees of the Medicaid and FAMIS programs. Note: FAMIS MOMS will be implemented at later date to be announced. To find out more about how these services can benefit the families you serve, go to the DMAS Addiction and Recovery Treatment Services (ARTS) information page here.
Smiles For Children Celebrates Two Years, cntd.
Interested in partnering with DentaQuest to raise awareness about oral health for kids and pregnant women? Contact the
Smiles For Children Outreach Coordinator, Jackie Wake, at
[email protected].
Download the
Smiles For Children pregnant women one-page flyer
here to share with families.
Those covered by
Smiles For Children (
Medicaid or FAMIS enrollees, including pregnant women) can call 888-912-3456 to learn more about benefits or to find a dentist. Transportation and translation services may be available. For more information, visit
www.dentaquest.com/state-plans/regions/virginia/.
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