Feds Award V.I. Human Services $19.6 Million For Medicaid Processing System

The USVI is getting $19.6 million for its Medicaid claim processing system from the U. S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, according to Government House.

Since 2012, the department has contracted out those services with Molina Medicaid Solutions, acting Human Services Director Anita Roberts said in a statement.

When Medicaid members get services the system, called a Medicaid Management Information System, handles health care claims for Medicaid covered services. Claims can now be submitted electronically to the Medicaid Program through the VIMMIS, which is consistent with federal Health Insurance Portability and Accountability Act requirements. This is real-time claim status and payment information available to the provider and the claim submitter, Government House reported in a Monday news release.

"Our access to this technology places the Virgin Islands on the same playing field with the other states. Moreover, these claims are adjudicated within six seconds," Roberts said in the release. "This ability has hastened timely payments to enrolled providers each week. Enrolled providers can verify member eligibility, obtain real-time claim status, receive electronic remittance advices, and submit requests for authorizations on-line through the secure Provider Web Portal."

Human Services has entered a new contract with Molina Information Systems Inc., which does business as Medicaid Solutions. The new contract runs from Sept.1 , 2016, through Dec. 31, 2022.

“We are extremely confident that Molina will provide the outlined services that are agreed upon with professionalism and in the interest of the Virgin Islands Medicaid subscribers," Roberts said "The MMIS enables the V.I. Medicaid Program to accurately track and report its use of federal funds as well as the local share (match), which was not the case prior to the implementation of the MMIS. Our partnership with Molina Medicaid Solutions validates the Virgin Islands’ use of a CMS Certified Management Information System.” 

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