Centers for Medicare & Medicaid: HHS Extends Postpartum Coverage in Virginia for Nearly 6,000 People

BALTIMORE, Maryland, Nov. 19 -- The U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services issued the following news release on Nov. 18, 2021:

The Biden-Harris Administration, through the Centers for Medicare & Medicaid Services (CMS) today approved extended Medicaid and Children's Health Insurance Program (CHIP) postpartum coverage in Virginia. This will provide access to essential care for an estimated 6,000 Virginians and provide peace of mind for people enrolled in Medicaid and CHIP, who will now be able to keep their coverage for 12 months, or regain coverage within that 12-month period, after childbirth. This important approval step will help Virginia expand access to needed pregnancy-related care, with the goal of preventing unnecessary postpartum-related illnesses and deaths. Today's announcement, made at a maternal health event in Virginia, advances the Biden-Harris Administration's strategy to address the nation's crisis in pregnancy-related deaths and will improve health outcomes among underserved communities through expanded access to critical care.

"Becoming a parent is among life's greatest milestones, but sadly paired with significant challenges for many in low-income communities," said Health and Human Services Secretary Xavier Becerra. "I applaud Virginia for taking action to provide vital, continued care for new parents and their precious newborns. This expansion of postpartum coverage will not only improve health outcomes for thousands of Virginians - it will save lives. The Biden-Harris Administration encourages more states across the country to adopt this expansion and support healthy parents and babies."

"It is a privilege to partner with the Commonwealth of Virginia to expand access to life-saving postpartum coverage and care," said CMS Administrator Chiquita Brooks-LaSure. "Improving maternal health outcomes--particularly among underserved communities, including among people of color--is a top priority for the Biden-Harris Administration. Today's action advances our commitment to improving the health of low-income pregnant people and their babies and preventing pregnancy-related illness and death."

This extended coverage comes through an amendment to the Virginia Family Access to Medical Insurance Security (FAMIS) MOMS and FAMIS Select Demonstration, which aligns with coverage options available under the American Rescue Plan (ARP). Thanks to the ARP, states will have the option (beginning April 1, 2022) to extend coverage for postpartum individuals beyond the required 60-day postpartum period through the end of the month in which a 12-month postpartum period concludes. Virginia's demonstration provides authority to implement a similar coverage expansion, beginning on November 18, 2021.

CMS is also approving Virginia's request to provide coverage to those postpartum individuals who are beyond the 60-day state plan postpartum period but who are still within the 12 months post-pregnancy period. This means that individuals who are eligible for extended postpartum coverage may be enrolled in Medicaid or CHIP for the purpose of receiving the extended postpartum coverage benefit at any time during the 12-month period following the end of pregnancy. Individuals enrolled in the extended postpartum coverage period not immediately following pregnancy but at a later point in time within the 12-month coverage period are only eligible for the period of time that remains prior to the end of the 12th month following the end of pregnancy. For example, an eligible individual who was enrolled in the fourth month following the end of the pregnancy will only be eligible to receive eight months of extended postpartum coverage.

The Biden-Harris Administration is committed to addressing the health disparities that underlie our health system. Actions under the Build Back Better agenda will provide significant funding towards improving maternal health and tackling health disparities. On April 12, 2021, HHS recognized Black Maternal Health Week by announcing actions to expand access to continuous health care coverage, as well as access to preventive care in rural areas in order to improve maternal health outcomes. The Administration also issued the first-ever presidential proclamation on Black Maternal Health Week, calling on the country to recognize the importance of addressing the crisis of Black maternal mortality and morbidity.

Medicaid covers nearly one in five women of reproductive age and makes pregnancy-related care accessible for more than 40 percent of people giving birth. Currently, a third of maternal deaths occur between one week to a year after childbirth, and Black women suffer three to four times more pregnancy-related deaths than white women. Providing continued Medicaid and CHIP coverage helps ensure access to the ongoing care people need during the postpartum period. The continuity of coverage available through this demonstration can help postpartum people manage chronic conditions like hypertension and diabetes, and provide access to behavioral health and other mental health care services.

This demonstration amendment will also ensure that the state can receive enhanced funding for expenditures related to eligible people who remain covered through the demonstration and who would otherwise qualify for the Medicaid expansion adult group.

As part of this approval, Virginia has agreed to undertake monitoring and evaluation of the demonstration for the extension period, in alignment with any applicable CMS-provided technical assistance.

For more information on the amendment to the section 1115 Virginia FAMIS MOMS and FAMIS Select Demonstration, visit: https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83426.