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The purpose of this bulletin is to serve as a reminder to providers delivering prenatal and postpartum care services to individuals of eligibility rules surrounding the end of the postpartum period for pregnant individuals. Most pregnant individuals are re-evaluated at the end of the 60-day postpartum period. Please see the below guidance for special processes during the COVID health emergency period.

During the COVID-19 Public Health Emergency (PHE):

• Most members enrolled in Medicaid for Pregnant Women and postpartum members enrolled in non-pregnancy related coverage are protected by the COVID-19 Federal (PHE) Maintenance of Effort and will not have benefits reduced or terminated unless they are reported deceased, move permanently from the state, or request closure of their benefits.
• Members enrolled in FAMIS MOMS, FAMIS Prenatal Care, or CHIPRA-214 individuals enrolled in Medicaid for Pregnant Women are re-evaluated at the end of their 60-day postpartum period for eligibility in other coverage groups and enrolled in ongoing eligibility or closed if no longer eligible as this population is not protected by the Maintenance of Effort.

Post COVID-19 PHE:

• After the end of the COVID-19 Public Health Emergency, all members must have their eligibility reviewed before reduction or closure of benefits. When individuals are found eligible for ongoing coverage, they are moved to a new coverage group with no break in eligibility.

When members have their eligibility reviewed, they may remain eligible for full or limited coverage. Individuals who have provided all information necessary to review their eligibility and are not enrolled in Medicare who are found ineligible for full coverage are referred to the Federal Marketplace to be evaluated for a Qualified Health Plan or Advanced Premium Tax Credits. Thank you for continuing postpartum care to these individuals and all of Virginia’s members.