‘If CNMI has no $5M local match, it must return $28M Medicaid federal allotments’

Christina E. Sablan

If there is no available $5 million local match for Medicaid’s federal allotments for fiscal year 2023, the CNMI must return $28 million in available funds, according to acting director for the CNMI Medicaid Agency Vicenta Borja last Thursday.

Speaking at the House of Representatives Health and Welfare Committee’s meeting in the House chamber, Borja said they are close to depleting the American Rescue Plan Act funding so she would have to stop their providers.

“If we don’t get the support for fiscal year 2023 local matching, we may have to shut down some services and cut off a lot of the programs that we implemented during the public health emergency [where] we have temporary authority, including Presumptive Eligibility,” she said.

Borja said these are the choices that they have make unless they go on a deficit.

The Health and Welfare Committee, chaired by Rep. Christina E. Sablan (D-Saipan), called for a meeting to receive updates from the CNMI Medicaid on local Medicaid matching requirements, Presumptive Eligibility, and other matters. Borja assumed the acting director position last mid-April after former director Helen Sablan left last February.

Borja said that she prioritized this local match issue since taking over the position.

“I did my internal research as far as we need and what we need to do,” said Borja, adding that she reached out to the Saipan and Northern Islands Legislative Delegation, which advised her to inform the administration as well as the Finance secretary, which she did back in May.

Borja said they have also been in communication with the Senate so she has provided them as much information as they would ask for.

“But I have not received any solutions. So I don’t know,” she said.

Rep. Sheila Babauta (D-Saipan) said they need to get this issue resolved before Sept. 30, 2022. “We need to start putting our heads together in finding the $5 million,” Babauta said.

As to what the impact would be on the Commonwealth Healthcare Corp. if the CNMI were to return the $28 million, Borja said the people who will be impacted are not only residents seeking health care, but especially patients who are off island for medical referral.

“They are [going to] be the ones who’ll suffer the most in this situation,” Borja said.

Borja said under Public law 22-08 or the Fiscal Year 2022 Budget Act, they were only appropriated $380,000 for reimbursement purposes because an assumption was made that the ARPA appropriation could be used to supplement the local Medicaid matching requirement. However, she said, she discovered that the Department of Treasury issued an interim rule regarding other restrictions on the use of payments from the fiscal recovery funds that it may not be used to pay Medicaid.

Borja said in order for them to maximize the over $100 million federal allotments that were set to expire this Sept. 30, they would have needed an additional $7.2 million from the general fund to match. She said, however, they may not need the entire money anymore and just hope that they receive enough matching to at least exhaust the 11-week funding, which is the bulk of their federal allotments. Borja said as of Wednesday, they still have about $28 million of the $62 million available.

“I have had discussions with the administration and the Senate in regards to this issue and was informed we will be meeting soon,” she said.

The acting director said she, however, welcomes other options, ideas, or solutions to address the need for the local matching, including a reasonable amount.

She said they are seeking an additional local appropriation to match 50% needed for the administration in the amount of $241,049.