ST THOMAS, USVI -- Governor John de Jongh said on Friday that the Centers for Medicare and Medicaid Services (CMS) has notified the Department of Human Services that the US Virgin Islands is eligible to receive a 2.2 percent funding increase to further expand the Medical Assistance Program. The increased funding is a result of stipulations in the Affordable Care Act.
De Jongh explained that the USVI government complied with the federal requirement for eligibility by successfully demonstrating how the territory provided health benefits coverage since 2010 to all residents including childless adults on the territorial poverty level who received services at local health clinics and hospitals.
“I was pleased to receive the letters from CMS which indicate the success of the strategic plan that I put in place as a healthcare legacy item for the territory during the Age of Health Reform and availability of additional federal funding,” he said.
He explained that this was made a priority during 2013 and 2014 to encourage an increase in Medicaid local match funding specifically to be used to expand the program both in terms of Medical services offered and new eligible person coverage categories.
“I encourage all residents who are uninsured to visit the Department of Human Services to determine if they are eligible for coverage. For those persons who are deemed not eligible, members of my staff continue to dialogue with insurance carriers and interested parties to develop a mechanism of coverage for gap populations who currently cannot find individual insurance coverage or affordable small group insurer coverage in our current market,” de Jongh said on Friday.
The Federal Medical Assistance Percentage (FMAP) of 2.2 percentage points is a temporary increase to 57.20 percent federal share that will be applied through December 31, 2015, to MAP expenses for eligible enrolled clients. Increased federal spending allows for greater savings to the territory. For example, if $1million were spent through MAP under the current match of 55.00 percent, the federal contribution would be $550,000 and the local match would be $450,000. With the increase, the federal contribution would be $572,000 and the local match would be $428,000. With anticipated annual Medicaid expenses of $20 million, savings to the V.I. government would be $440,000.
The US Virgin Islands government is also eligible for enhanced match to cover Medicaid benefits to a new population comprising of non-pregnant, childless adults – including the homeless -- who were not covered prior to the Affordable Care Act. Human Services intends to cover this group in planned Medicaid expansion over the next few months. CMS will initially pay 78 percent of the cost to expand MAP to this new population and will increase their share to 90 percent by the year 2019. As this vulnerable population also potentially includes persons with some mental illnesses, this may go a long way to assist closing mental health system gaps in the territory for this specific population.
Human Services Commissioner Christopher Finch was encouraged by the news.
“Although the 2.2 percent is a modest increase, it’s a step in the right direction. The federal share of 78 percent for childless adults is indeed exciting news. I want to thank the staff at Human Services, Government House and the consultants at Mercer Health and Benefits as well as the staff of the Region II CMS office who all worked on this project,” he said.
Through use of the recently implemented Medicaid Management Information System, claims for this new population can be accurately identified which allows for better tracking of client utilization of services and management of scare and prudent spending of general fund coffers.
Additionally, de Jongh said he was pleased by the additional news that a State Plan Amendment (SPA) for new physicians’ fees for services provided at both territory hospitals was approved by CMS on March 27, 2014. He explained that the change in the service rate to allow physicians to be paid by Medicaid at 100% of Medicare negotiated rates for either inpatient or outpatient services at the hospital serves to better ensure that referral gaps are closed for Medicaid patients.
“This change does not preclude the hospitals for invoicing the Medicaid program for facility fees associated with the overhead of providing these procedures on-site at the facility,” he said.