‘HNP deficit now over $800K’

With its limited funding from the CNMI government, the former Medical Referral Program, now called the Health Network Program, is already in deficit that, as of last week, has already reached over $800,000.

In a letter to Gov. Arnold I. Palacios on Thursday, Commonwealth Healthcare Corp. chief executive officer Esther L. Muña underscored the need for urgent funding for the program, saying that services and benefits for referral patients will continue to be reduced and/or eliminated unless the program received sufficient funds. Muña said any reduction and/or elimination will have the potential to impact the health outcomes of those requiring access to care that are not readily available on-island.

Muña said the law that created the HNP included ensuring that the program operates had a budget appropriation. In line with that law, CHCC asked for funding in the second and third quarters of fiscal year 2023. Muña said they asked for about $3 million every quarter, and that for two quarters they didn’t get that.

In her letter Thursday to Palacios, Muña said that, with the continuous limited appropriation for the program, CHCC was forced to make immediate changes to stay within the budget given to the CHCC to operate it. Those changes include transferring HNP employees to hospital operations, terminating blocked rooms in Los Angeles as they become empty, and terminating 10 additional rooms in Guam.

Other changes are shifting use from travel agents to online purchasing of airline tickets for patients and their escorts, leaving vacant positions in Guam and Hawaii unfilled, and terminating benefits when the program is not obligated to cover.

Esther L. Muña

This week, Muña said, they have taken steps to forewarn patients that subsistence will pause until funding is received from Saipan Local Law 23-01.

In the meantime, consistent with Public Law 22-33, CHCC is implementing immediate measures pertaining to airline tickets, lodging/housing, ground transportation, medication access when Medicaid is not accepted, medical evacuations, and HNP assistance.

On airline tickets, patients with Medicaid coverage can receive airline tickets for themselves and their approved escorts. Patients with no airline benefits must pay for the airline tickets for themselves and their escorts.

On lodging/housing, this will be provided in Guam and Hawaii when blocked rooms are available. Priority will be given to those with acute medical needs. Housing will stop in the continental United States, except for the patients already there. However, once blocked rooms are vacated, they will be terminated.

Ground transportation will be provided in Guam and Hawaii for all approved referrals to the two locations. Transportation will discontinue in the continental U.S.

Prepayment for medications for Medicaid patients in the continental U.S. will continue.

Hospital-to-hospital medevacs will continue.

HNP staff will continue to provide appointment assistance with partnering facilities and look for insurance-covered benefits and the most cost-effective means of transport to minimize the individual’s financial burden. The HNP Medical Committee will continue to review referrals for necessity and if the regulations cover the service.