Caribbean News Now!

ST THOMAS, USVI -- Governor John de Jongh has announced a landmark partnership in which the US Virgin Islands will be incorporated into West Virginia's state-of-the-art Medicaid Management Information System (MMIS), reducing costs and improving services to the territory's Medicaid recipients.

The historic agreement will allow West Virginia's system to handle claims generated by the territory's Medicaid population.

De Jongh signed a memorandum of understanding with the state of West Virginia in 2011 detailing the sharing of the MMIS platform and on October 5, 2012, executed the contract with the system provider, Molina Medicaid Solutions.

The contract was subject to approval by the Centers of Medicare and Medicaid Services (CMS) and went through several rounds of review over the last two months at the federal level.

The project was born out of an informal conversation de Jongh had with former West Virginia governor and current US Senator Joseph Manchin III during the Democratic Governors Association (DGA) meeting the USVI hosted in 2008. De Jongh described the territory's challenges, and Manchin, who at the time was serving as head of the DGA, revealed that his state had automated and upgraded its claims reimbursement Medicaid system in the mid-2000s

“I can't thank Senator Manchin and current Governor Earl Ray Tomblin enough. Senator Manchin told me four years ago that West Virginia could help the Virgin Islands attain access to a state-of-the-art system, and he followed through with his promise,” de Jongh said.

“West Virginia's system, operated by Molina, is the first to be certified under the Department of Health and Human Services Seven Conditions and Standards for Enhanced Funding. By using that service to transform our Medicaid system, it allows us greater access to further federal assistance down the road and throughout the period of Health Care Reform,” de Jongh said.

The MMIS technology will ensure the integrity of the Medicaid claims process by enhancing reporting and accountability. It also will improve services to beneficiaries, allow timely payments to providers, and facilitate collection of important claims data that can be used to further improve the Medicaid processes and enhance the quality of care to the territory's Medicaid beneficiaries.

“We’re excited to be a part of this historic partnership,” said Mario Molina, MD, president and chief executive officer of Molina Healthcare. “We look forward to continue supporting the State of West Virginia and now the US Virgin Islands in providing the Medicaid populations in both areas with access to quality health care. We are confident that our federally-certified system in West Virginia will be able to assist in doing this efficiently and effectively in the US Virgin Islands as well.”

The Virgin Islands MMIS implementation plan has been approved by the Centers for Medicare & Medicaid Services. As a result, the Virgin Islands will be the first territory to have a certified system. Establishing an MMIS independently would have cost in the tens of millions of dollars. The official MMIS project kickoff occurred on October 9 and will continue through October 19.

The USVI Department of Human Services (DHS) is hosting representatives from Molina during this working session and USVI participants include representatives from DHS Family Services, the Bureau of Health Insurance & Medical Assistance (BHIMA), the Office of the Governor, the Department of Health’s Information Technology (IT) unit and the Department of Finance.

The goals of this session are continued mapping of the MMIS project implementation plan and timeline, “live” systems review of specific claims processing scenarios and in depth breakout sessions on USVI IT Infrastructure mapping, financial cycle systems builds and systems and business rules configuration.

Discussions will also occur next week on how the MMIS system will coordinate interface options with the USVI’s Enterprise Resource Planning (ERP) fiscal system.

The kickoff follows the recent transfer of the Medicaid Program (BHIMA) from the Department of Health to the Department of Human Services and provides opportunities for DHS staff responsible for programs such as Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) to get a hands on feel for the design of system modules and a context for how their programs will integrate with Medicaid to provide a “one-stop” shopping experience for families potentially eligible for all three programs.

The transition of BHIMA to DHS also provides the opportunity to leverage human capital in the areas of eligibility determination, fraud/waste review and compliance monitoring.

“This partnership will save money for the Virgin Islands and all federal taxpayers,” said Cindy Mann, deputy administrator and director of the Center for Medicaid and CHIP Services. “We are excited at this historic partnership and at the development by the Virgin Islands of these important administrative systems that will help them administer their Medicaid program more effectively.”

Beyond the immediate benefits to the Virgin Islands, the first-of-its-kind partnership serves as a model for the entire country by demonstrating that state and territorial governments can reduce local and federal costs by sharing such technologies.

The Virgin Islands is expected to be fully incorporated into the system and “go-live” by July 2013.

“Once the president's health reform act passed, it was clear we would be managing millions of dollars more than we had before and our manual system would struggle to handle the increased load. It was at that point we sent a delegation to West Virginia to learn about their system and began establishing a working relationship between the two departments of health,” de Jongh said.

A quarter of the Virgin Islands population is uninsured, according to a recent survey.

“We need to expand our Medicaid program and bring down the rate of uninsured. This partnership will be a huge step toward achieving that goal,” de Jongh said.

Reads: 2255


Tweet