Medicaid benefits expected to continue in October 2019

The Saipan Medicaid Office has completely exhausted all its federal and local funding for fiscal year 2019, but expects it to continue at the start of fiscal year 2020 in October 2019.

Effective June 1, 2019, Medicaid beneficiaries can avail of the Commonwealth Health Care Corp.’s clinics for outpatient care since it is the only agency designated as a medical provider for all children and adult outpatient care.

“Services provided by the Kagman Community Health Center, MMC & Pacific Labs, LLC, Pacific Medical Center, and Saipan Health Center will not be reimbursed by the CNMI Medicaid Program for outpatient care,” said a statement in the Saipan Medicaid website.

This means that these clinics will ask you for cash payment instead of billing Medicaid for services provided.

Exceptions are reserved for medically necessary outpatient services that are not immediately available at the Commonwealth Health Center. However, in order to be exempted, prior authorization must be obtained from CHCC.

“CHCC has committed to schedule appointments within three weeks of the request and to initiate treatment for urgent walk-in services within two hours,” the office noted.

The authorization is through a certificate signed by CHCC chief executive officer Esther Muña or any of the CHCC clinic directors at the time you are seeking the service. The certificate would then be presented to the medical provider in exchange for the services.

“…We are in process of reviewing all services funded by the CNMI Medicaid program to assess whether they can be reduced or eliminated to reduce expenses,” CNMI Medicaid director Helen C. Sablan told service providers in a statement.

“While we hope that you might consider continuing to provide medical care for some of the Medicaid beneficiaries as charity care or through some arrangement directly with the patient, please be advised that any such agreement is between you as a provider and the patient—the CNMI Medicaid program will not reimburse you or the patient for any of these services,” she continued.

These developments were also stated in a press conference last Wednesday.

For more information, visit the CNMI Medicaid program website at http://medicaid.cnmi.mp/ or call their office at 664-4880 or 664-4890.