VI Medicaid Patients Go Without Care As Contracts Linger In Government Bureaucracy

ST. CROIX — Many Virgin Islands residents who depend on Medicaid, called Medical Assistance Program (MAP) in the territory, have been unable to receive medical care because a number of Virgin Islands physicians, as of Friday, had yet to receive approval for their MAP provider agreement, email conversations between Senator Nereida Rivera-O’Reilly, along with Department of Human Services (D.H.S.) and Department of Justice officials have revealed.

The D.H.S. Bureau of Health Insurance and Medical Assistance is the division responsible for administering Medicaid in the Virgin Islands. But for reasons unknown, the government has been slow in approving multiple contracts. Mrs. Rivera-O’Reilly, in multiple emails last week and over the weekend, assailed government officials for the stalled progress in getting the contracts signed, contending that it sends a message to the U.S. Government and President-elect Donald Trump, that the territory has no use for Medicaid dollars.

“I am distraught by the fact that VI physicians are still waiting for approval of their MAP provider agreement. Several applications continue to linger. In the interim people go without access to medical care and our MAP expansion dollars go unspent. So we are essentially sending a message to congress and now Trump that the VI doesn’t need MAP money and has no need for improved medical services and access to health care,” Mrs. Rivera-O’Reilly, who was recently reelected to serve in the 32nd Legislature, charged. “I am confused. I am confounded. I am fit to be tied. I am at the end of the proverbial rope. Either do your job or move aside and let someone else capable and willing do it. I am tired of hearing the same complaints and excuses. I need a response.”

Mrs. Rivera-O’Reilly inquired about the status of VI Equicare’s contract, and mentioned at least one doctor’s contract that was in limbo. Founded in 1997, VI Equicare is the largest independent preferred provider organization in the U.S. Virgin Islands, with a goal to increase the availability of affordable healthcare in the territory, according to a blurb on the About Us page of the firm’s website. Furthermore, the company provides a single contracting authority for a wide range of medical initiatives for insurance carriers, third party administrators, employers, and the cruise line industry. Within its network of healthcare providers, VI Equicare performs a number of service and organizational functions including credentialing, education and information, quality assurance, and communication, according to information on the company’s website.

Yet, the status of VI Equicare’s contract, which Attorney General Claude Walker revealed through email had been sent to Government House on September 26, remains unknown. Mrs. Rivera-O’Reilly pounced, lashing out at Mapp administration officials for their lack of urgency on the matter.

“Please find the contract!” she demanded. “Sick people relying on MAP get sicker because their government has no sense of urgency. What is the written procedure governing the processing of contracts? Who keeps track of the date it was written, reviewed, revised, signed, and moved from one government dark hole to the next? Folks we are doing our people a disservice. It is never a holiday for elected officials.”

Mrs. Rivera-O’Reilly reached out via email to Commissioner-Designee of D.H.S., Dr. Anita Roberts, on Thursday, received an initial response the same day stating that Ms. Roberts would direct her chief of staff, Pamela Richards, to look into the matter. Governor Kenneth Mapp’s chief legal counsel, Emile Henderson, was also cc’d in the conversation, as Mrs. Rivera-O’Reilly worked to add pressure.

On Friday, Ms. Richards responded, stating that D.H.S. had an “executed MAP contract.” But she did not specify when the contract was signed and whether there were multiple MAP contracts, representing various firms, that needed to be signed, or if the “executed contract” was universal, and would allow physicians to provide Medicaid services to Virgin Islands residents.

Ms. Richards also responded to another query involving the closure of the Estate Profit Head Start facility, which was reportedly being closed. Ms. Richards said the facility “and some of the roofs for the walkways have some repair issues, but is nowhere near being [at] “condemned” status.” She said the property is managed by the Department of Sports, Parks and Recreation, and that she would reach out to officials there for assistance.

Correction: November 15, 2016

A previous version of this story, because of a text error, included an incorrect last name for D.H.S.’s commissioner-designee. It’s Anita Roberts, not Anita Davis. The story has been updated to reflect the correct information.