2/1/2026 2:03:18 AM
For Provider Training Sessions click "Announcements" to select the Provider Enrollment Kickoff document and open attachment! The sessions scheduled are in support of the launch of the USVI Medicaid Provider Enrollment Application (PEA) solution. These sessions are scheduled February 17th & 19th . Providers and their office staff will have the opportunity to join one of the many sessions, either in person or remotely, to learn more.
2/1/2026 2:02:48 AM
Attention Providers, Coming Soon
The US Virgin Islands Department of Human Services (USVI DHS) Medicaid Program is pleased to announce that it will be deploying a new solution for its providers on the USVI Medicaid Management Information System (MMIS) Web Portal in early 2026 that will process Medicaid Provider Enrollment Applications in an efficient and automated process in compliance with CMS federal guidelines and local Medicaid policies.
What That Means for USVI Medicaid Providers
This new USVI Medicaid Provider Enrollment Application (PEA) Process will enable provider applicants to enter their enrollment application information into the USVI Medicaid Management Information System (MMIS) Provider Web Portal, and track their application progress, as well as allow Enrolled Medicaid Providers to maintain their data and credentials on an ongoing basis.
Coming Soon! Provider Training Sessions will be scheduled in support of the launch of the USVI Medicaid Provider Enrollment Application (PEA) solution. These sessions will be scheduled in January and February 2026. Providers and their office staff will have the opportunity to join one of the many sessions, either in person or remotely, to learn more.
2/1/2026 2:02:08 AM
The USVI Medicaid Program will continue its waiver/overrides of prior authorizations for ON-ISLAND services effective thru June 30, 2024.
Dental (Codes Requiring PA are listed on the portal), PCA, Hospice, Home Health Care, DME, and Off-Island services are excluded from the waiver.
2/1/2026 2:00:16 AM
Google Chrome and Microsoft EDGE web browser versions have been updated to Chrome: 91.04.4472.77 and EDGE: 91.0.864.37. These versions include updates that are not compatible with the Health PAS-OnLine web portal. Users are experiencing blanks screens or display error messages. It is recommended that users utilize Internet Explorer 11, Safari, Firefox, or another web browser until the Chrome/EDGE issue is resolved. Click Announcements, then Chrome and EDGE Web Browser Updates, then review the document with instructions on updating IE11 privacy settings to make IE11 compatible. The following Chrome version: 90.0.4430.212 and EDGE version: 90.0.818.66 is still compatible by updating the samesite flags. Instructions on how to update the flags, can be found by clicking on Announcements, Chrome and EDGE Web Browser Updates, then the Samesite Flag Updates for Chrome and EDGE document.
The team is working diligently to resolve these issues and expect an update very soon. If you have any questions concerning this information or these instructions please contact the USVI EDI Helpdesk at (855) 248-7536.
2/1/2026 1:54:48 AM
The View Payment Detail tab
is not functioning as expected by indicating “No Payments were found”. To
view payment details, click the Search
hyperlink located on the right. Enter the search criteria such as Payment Number or Payment From Date
and Payment To Date then click the SEARCH button below. The Payment
Details information will display.
2/1/2026 1:52:57 AM
Medicaid members may update their contact information online by utilizing the following link: https://vibes.usvi-cloud.com/CitizenPortal/application.do
This is a web-based tool that allows Members to update their physical mailing address, their cell phone, and their email address to receive information concerning their upcoming Medicaid renewal.
2/1/2026 1:48:10 AM
PROVIDERS, we need your help. Help us keep the Medicaid population in the know. Many Medicaid members will lose their coverage.
If a patient has lost their coverage and believes they still qualify for Medicaid, the patient should complete a renewal form.
- Across the nation, the Public Health Emergency has ended, including the continuous coverage provision for Medicaid. Many Medicaid members will lose coverage.
- All Medicaid members in USVI must complete the renewal process with the USVI Department of Human Services to see if they still qualify for Medicaid.
- If a patient has lost their coverage and believes they still qualify for Medicaid, the patient should check their US mail for a renewal form. If they did not receive a renewal form, they should email sttjmap@dhs.vi.gov or call 340-715-6929 for St. Thomas/St. John, or stxmap@dhs.vi.gov or call 340-772-7100 x7114 or x7115 for St. Croix to renew.
- They will need to provide current proof of income, residency, and citizenship status to complete the renewal.
- If a patient has lost coverage but still qualifies for Medicaid, once they complete the renewal, benefits can be applied retroactively. Please contact the Medicaid office on St. Thomas or St. Croix for further detail.
Thank you!
2/1/2026 1:45:56 AM
Please click on Announcements, then Codes Which Will Continue to Require Prior Authorization and review the attachment.
2/1/2026 1:44:09 AM
Please click on Announcements, then Medicaid Referral Process by Provider Type - On-Island Services, and read the attachment for more information.
2/1/2026 1:41:40 AM
Please click on Announcements, then 2024 USVI Medicaid Enterprise Systems Summit, and review the attachment regarding the 2024 USVI Medicaid Enterprise Systems Summit.
2/1/2026 1:38:50 AM
Announcing Temporary Service Adjustments
Please click on Announcements, Announcing Temporary Service Adjustments, and then review the Press Release attachment concerning an announcement by the Department of Human Services (DHS) concerning the temporary service adjustments to the Medicaid program.
2/1/2026 1:36:23 AM
Gainwell Technologies will be hosting a Webinar on Thursday, October 12, 2023 at 2:00 pm EST.
This webinar will provide training and discussion on the VIMMIS web portal, reviewing the updated VIMMIS Web Portal User Guide, electronic claim submission and electronic claim submission response files. A provider Q&A session will be available at the end of the training. The meeting details are available in the VIMMIS Webinar Meeting ID document. To reach the document, click on Announcements, then Provider Webinar Training for VIMMIS, and locate the VIMMIS Webinair Meeting ID document.
We hope you will be able to attend.
Thank you.
2/1/2026 1:32:22 AM
2/1/2026 1:31:10 AM
Register for the Second Annual Digital Health Summit in St. Thomas USVI, June 13 – 16.
Registration is free, but mandatory.https://ohitusvi.com/summit/
1/31/2026 11:57:13 PM
Medicaid Program Public Notice Qualifying Clinical Trials Coverage
The Department of Human Services (DHS) is issuing this Public Notice of its intention to establish coverage of routine Medicaid patient costs associated with participation in qualifying clinical trials under the United States Virgin Islands Medicaid Program (USVIMP) effective May 09, 2023.
Please click on Announcements, go to Medicaid Program Qualifying Clinical Trials Coverage, and review the attached PDF document for additional information.
1/31/2026 11:55:47 PM
Electronic Claim Rejection Error Notification
Gainwell Technologies is aware of an issue that resulted in electronic X12 claims rejecting incorrectly on the 824 and BRR reports. Electronic claims submitted between 02/20/2023 and 11/08/2023 may have rejected incorrectly for an invalid provider, member, or NDC number and should be resubmitted. This issue was resolved Wednesday 11/08/2023 at 11:50 AM. Please note this issue did not affect claims keyed directly on the VIMMIS web portal. We apologize for this inconvenience. Please contact the VI EDI Helpdesk at 855-248-7536 or VIEDIHelpdesk@gainwelltechnologies with any questions or concerns related to the notification.
1/31/2026 11:55:07 PM
ANNOUNCEMENT for ALL PROVIDERS
The Department of Property and Procurement is transitioning to a New ePro System (GVIBUY) and is requesting that ALL PROVIDERS self-register. Registration in the system is pertinent as it does affect future payments. Please click on Announcements, go to the EPro System Notification and refer to the attachments for further clarification and guidance. If any Provider needs assistance, the Vendor Management Staff at the Department of Property & Procurement will be available to assist.
The system goes live in February, and all Providers are encouraged to self-register as soon as possible. The registration is straightforward and must be completed before 01/28/2022.
1/31/2026 11:45:21 PM
Receiver ID and Sender ID Changes
Gainwell will update the Receiver ID format for EDI inbound files and the Sender ID for EDI outbound files after business hours on July 8, 2022. The current format VI_MMIS_4_DXCMS will be updated to VI_MES_4_MMS_IG. Gainwell will continue to accept and process all EDI inbound files received with VI_MMIS_4_DXCMS after the deployment date. ALL OUTBOUND acknowledgement and response files will be transmitted with the new Sender ID after the deployment date.
The Companion Guides, located under Reference Material, have been updated with the new Sender ID and Receiver ID information and examples. For assistance concerning these changes please contact the Gainwell EDI Helpdesk at 855-248-7536 or viedihelpdesk@gainwelltechnologies.com