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Human Services Extends MAP/MEDICAID Benefits To Members and Providers

CHARLOTTE AMALIE — The Department of Human Services (DHS) said it “is working around the clock with their federal partners to ensure that Virgin Islanders have access to all provisions that will be of help during this crisis.”

“DHS staff members are implementing changes in record time and working to ensure that the various programs can keep pace with the new surge in need and demand for critical cash, food, medical, childcare and energy assistance benefits,” Human Services Commissioner Kimberley Causey-Gomez said.

The Department of Human Services exists to advocate for our vulnerable populations and ensure that all Virgin Islanders have access to much needed resources during this time of crisis, according to Causey-Gomez.

The Medicaid Program (called Medical Assistance Program locally) is a critical government-sponsored program that aids with health care coverage to uninsured or under-insured people with low-incomes.

Human Services employees are also on the front lines every day and serve the Virgin Islands community as essential employees in this time of crisis, national uncertainty and hardship.

The Medicaid Program, funded by the federal government and administered at the state/territory level provides a variety of assistance services like doctor visits, long-term medical, custodial care costs, hospital stays, and more.

Additional Member Benefit Flexibilities

To help in this time of crisis, the DHS administered Medicaid Program is currently offering the following member benefits:

  1. Automatically extend all Medicaid/ Children’s Health Insurance Program (CHIP) re-certification’s for six months, thus promoting social distancing, health and wellness for our clients and staff alike.
  2. Eliminate current requirements for members to get referrals for specialists and to get prior authorization. This means, during this time of hardship, MAP member will not have to get a referral from their primary doctor or public providers and a prior authorization
    (except for certain dental and durable medical equipment) from the Department of Human Services prior to schedule an appointment with a private provider or specialist. This will enable our members to receive services from any enrolled Medicaid provider without any referral or prior authorization.
  1. Extend Presumptive Eligibility already being performed in the hospitals, Federally Qualified Health Centers (FQHCs), and Department of Health clinics to pregnant women, the aged, blind, and disabled populations.
    a. We will extend the eligibility period for all Presumptive Eligibility applications for 90-days from the date of the application to support social distancing, while providing continuous eligibility for needed services.
    Presumptive Eligibility (PE) provides Medicaid benefits for a limited time while a formal Medicaid eligibility determination is being made by the Virgin Islands Department of Human Services. The goal of the presumptive eligibility process is to offer immediate health care coverage to people likely to be Medicaid eligible, before there has been a full Medicaid determination.
    Medicaid Providers
    For Medicaid Providers, the DHS Medicaid Program will extend the following temporary modifications:
  2. Postpone deadlines for re-validation of provider agreements for the duration of the COVID-19 Public Health Emergency. This is applicable for all providers currently enrolled in the Medical Assistance Program including off-island providers.
  3. Waive normal provider screenings and enrollment activities in those cases where a provider is already a participating Medicare provider or a participating Medicaid provider in another State or territory.
  4. Reimburse for hospital and other services rendered in an unlicensed facility which DHS can assess to reasonably meet minimum standards and expectations (including health, safety, and comfort for members and staff) consistent with the current COVID-19 Public Health Emergency guidelines for Medicaid members. This would apply in the event our hospitals became overwhelmed with patients.
  5. Provide clinically appropriate care using telehealth and telemedicine technology, primarily through DHS Department of Health Clinics, FQHCs, and our physicians. Providers will be paid the same rate for providing telehealth and telemedicine appointments as they would for a face to face encounter.
    We continue to work with our federal partner, Centers for Medicaid and Medicare Services (CMS), to ensure all the available benefits and authorities are implemented to allow us to provide quality health care services to the citizens of the U.S. Virgin Islands.

For more information, please visit the Department of Human Services website, www.dhs.gov.vi or on Facebook (https://www.facebook.com/usvidhs) at U.S. Virgin Islands Department of Human Services. Feel free to also email: sttjmap@dhs.vi.gov on St. Thomas and stxmap@dhs.vi.gov on St. Croix with questions or to submit documentation. Please ensure a working telephone number is on any application. Telephone interviews will be scheduled in lieu of face-to-face interactions.
Phone Contacts:
St. Croix: (340) 772-7117, or (340) 772-7100 ext. 7006, 7151, 7120
St. Thomas: (340) 774-0930 ext. 4308, 4324, 4318
Phone Contacts:
St. Croix: (340) 772-7117 or (340) 227-4686
St. Thomas: (340)725-5702
For more information on COVID-19, the new strain of coronavirus, please visit the USVI Department of Health’s website, www.doh.vi.gov/coronavirus or text COVID19USVI to #COVID19USVI

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