PUBLIC NOTICE

WVCHIP EXPANSION TO COVER MORE UNINSURED CHILDREN

On January 1, 2007, the West Virginia Children’s Health Insurance Program (WVCHIP) plans to review applications under expanded income eligibility guidelines. These new guidelines will allow those families to have health coverage for their children through premium payments. In addition, children must have been without private group insurance coverage for 12 months to be eligible.

Currently, a family’s gross income (before taxes) must be at or under 200% of the federal poverty level (FPL) for WVCHIP eligibility.  This expansion phase allows an increase to 220% of the federal poverty level to provide an opportunity for more uninsured children to have health care coverage through WVCHIP.

Example -- 2006 Income Eligibility Chart

  *Income Deductions/Exceptions may qualify some families whose income is above maximum level.

Families qualifying for the WVCHIP Premium Health Plan (201% - 220% FPL) would be charged an affordable premium of $35 per month for one child and $71 per month for two or more children.  Total cost of premiums and copayments will not exceed more than 5% of the family’s total annual gross income. Enrollees in the premium plan will have access to the same medical coverage as current members, but will not have vision coverage. Dental services will be limited to preventive services, such as semi-annual exams and x-rays. Visit www.wvchip.org for more information on copayments and benefits.

The application process for the premium plan is the same for all plans.  Families can apply for WVCHIP by calling the toll-free helpline at 1-877-982-2447, at their local DHHR office or by Internet at www.wvinroads.org.

Adoption of this change is estimated to provide comprehensive health care coverage to approximately 400 uninsured children of working families during the first year of implementation.

Any written comments concerning these changes should be made in writing thirty days of the date of this notice and addressed to:  Executive Director, WV Children’s Health Insurance Program, 1018 Kanawha Boulevard East, Suite 209, Charleston, West Virginia 25301, or you may email your comments to Brenda Jones at bkjones@wvchip.org.

BENEFIT CHANGES FOR THE 2005-2006 PLAN YEAR

• New Pharmacy Benefit Manager for Specialty Medications is CuraScript™.
• New Pharmacy Benefit Manager for Drugs Requiring Preauthorization is WVU’s School of Pharmacy Rational Drug Therapy Program.
• MRI’s no longer need to be pre-certified.
• NURSELINE has been discontinued.
• Chiropractic Services. Any member under 16 years old is required to submit x-rays and a treatment plan to Acordia National before authorization will be given.
• Immunizations. WVCHIP purchases vaccines from the State’s Vaccine for Children (VFC) program. Members should receive vaccinations from providers that participate in this program.

For more information, please review the July 2005 Summary Plan Description Booklet.

Benefit Change

NURSELINE has been discontinued.   For general health questions, members can call CAMC's Health Information Center at 1-888-432-5849 or WVU's Healthline at 1-800-982-8242.

2005 Provider Workshops

Coordinated Payor Billing Workshops

WV CHIP, PEIA, Workers Compensation, and Medicaid will all be participating in the Provider Workshops. 

Attendees will learn the latest changes and how they will affect you; the best way to bill each agency to assure quick, correct payment of claims; who to contact with which questions; and what to expect from new initiatives of the four state payors.

The schedule is as follows:

Monday, June 6                   (Flatwoods, Days Inn)

Tuesday, June 7                  (Beckley, Tamarack)

Wednesday, June 8             (Parkersburg, Holiday Inn)

Thursday, June 9                 (Huntington, Big Sandy Superstore Arena)

Monday, June 13                 (Martinsburg, Holiday Inn)

Tuesday, June 14                (Morgantown,, Ramada Inn)

Wednesday, June 15           (Wheeling, Ramada Plaza)

Friday, June 17                    (Charleston, Charleston Marriott)

For More Information, email:  JCunningham@wvadmin.gov .

Moving News

The West Virginia Children's Health Insurance Program (WVCHIP) has moved its administrative office location as of February 1, 2005. 

The new address is 1018 Kanawha Boulevard East, Suite 209, Charleston, WV  25301.  The main telephone number will remain the same:  304/558-2732.

CHIP Members May Qualify for Earned Income Tax and Child Care Credits

Thousands of West Virginians have taken advantage of the federal earned income tax credit, but more could be eligible.  Is your family one of them? 

The Earned Income Tax Credit (EITC) is a federal tax credit for people who work and have an earned income less than $34,692. This tax credit can reduce the amount of tax you owe and most likely put more money in your pocket.  A person with two or more qualifying children could receive up to $4,204.  Families can file up to three years back as well. You can also take advantage of the state tax relief, which would give you a zero taxable income for West Virginia.

You may also qualify for the Child Tax Credit (CTC), a federal tax credit worth up to $1000 per qualifying child. You may qualify for the CTC if you have earned income of more than $10,500 and you claim at least one dependent child under the age of 17.

Payment Accuracy Measurement (PAM) Demonstration Project

The West Virginia Children's Health Insurance Program (WHCHIP) is pleased to announce that it has received a grant from the Centers for Medicare and Medicaid Services for a Payment Accuracy Measurement PAM demonstration project. West Virginia is one of the 27 states to participate in this project in response to the Improper Payment's Information Act of 2002. The PAM Project will test the accuracy of Title XXI State Children's Health Insurance Program procedures and will ensure the integrity of eligibility, claims processes, and claims amounts within WVCHIP. This grant will enable this program to be piloted with 100% federal funding with the expectation of mandatory nationwide implementation.

Apply online using inROADS

Apply online using inROADS. Use inROADS - Information Network for Resident Online Access and Delivery of Services - to complete and submit an online health plan application. You can apply for Pregnant Women and Children Medicaid and the West Virginia Children's Health Insurance Program. Click https://www.wvinroads.org/ here to apply.