wp content uploads 2024 12 MAP Public Notice USVI Targeted Case Management Reimbursement
1303 Hospital Ground • Knud Hansen Complex, Suite 1 • St. Thomas, Virgin Islands 00802-6722 • (340) 774-0930 3012 Golden Rock • Christiansted, St. Croix, Virgin Islands 00820 • (340) 718-2980 MEDICAID PROGRAM PUBLIC NOTICE REIMBURSEMENT FOR ADDING TARGETED CASE MANAGEMENT AND RELATED REIMBURSEMENT METHODOLOGY December 30, 2024 As required by 42 CFR 447.205, the Department of Human Services (DHS) is providing this public notice of the proposed addition of Medicaid reimbursement methodology for targeted case management (TCM) as required by Section 5121 of the Consolidated Appropriations Act of 2023 (Section 5121). Section 5121 requires the provision of pre- and post-release TCM for eligible juveniles who are incarcerated. The proposed methodology would reimburse providers using the procedure codes and rates identified in the USVI Medicaid Fee Schedule. The annual aggregate expenditure for this new service is expected to be $15,000. USVI proposes to make the amendment effective on or after January 1, 2025. …
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1303 Hospital Ground • Knud Hansen Complex, Suite 1 • St. Thomas, Virgin Islands 00802-6722 • (340) 774-0930 3012 Golden Rock • Christiansted, St. Croix, Virgin Islands 00820 • (340) 718-2980 MEDICAID PROGRAM PUBLIC NOTICE REIMBURSEMENT FOR ADDING TARGETED CASE MANAGEMENT AND RELATED REIMBURSEMENT METHODOLOGY December 30, 2024 As required by 42 CFR 447.205, the Department of Human Services (DHS) is providing this public notice of the proposed addition of Medicaid reimbursement methodology for targeted case management (TCM) as required by Section 5121 of the Consolidated Appropriations Act of 2023 (Section 5121). Section 5121 requires the provision of pre- and post-release TCM for eligible juveniles who are incarcerated. The proposed methodology would reimburse providers using the procedure codes and rates identified in the USVI Medicaid Fee Schedule. The annual aggregate expenditure for this new service is expected to be $15,000. USVI proposes to make the amendment effective on or after January 1, 2025. USVI expects to submit the State Plan Amendment (SPA) to the Centers for Medicare & Medicaid Services (CMS) by March 31, 2025. Implementation of this change depends on approval by CMS. The Medicaid SPA that describes this reimbursement methodology will be available for review at: https://dhs.vi.gov/. It will also be posted for review at the DHS District Offices on St. Thomas, St. Croix, and St. John. You may also call 340-774-0930 on St. Thomas or 340-773-1311 on St. Croix. If you prefer to provide written comments on this proposal, please address them to the following: USVI Department of Human Services Attn: Director, Medicaid Program 1303 Hospital Grounds – Building A St. Thomas, US Virgin Islands 00802 We invite your comments on the proposal and those comments must be received by DHS within 30 days of the date of this notice.