Create commission for gov’t health insurance

Amid the controversy surrounding the $4 million outstanding account of the government health insurance with two health providers in Honolulu, the Northern Mariana Islands Retirement Fund Board Chair Vicente C. Camacho has urged the Legislature to create an insurance commission that will eventually takeover its management.

The Fund is now faced with the problem of how to settle its huge unpaid medical bills which the Straub Hospital and Queen’s Medical Center were demanding for the services they have rendered for the past two years. The government health insurance owes Straub and Queen’s $2 million and $1.8 million, respectively.

“I will lobby for that because I’ve been telling the Legislature that this program should be out of the retirement fund. I don’t know why the Fund should continue handling it since we are not in the business of managing health insurance,” said Mr. Camacho.

Mr. Camacho said he has always opposed the turnover of the health insurance to the Fund four years ago because it will be a big responsibility for the NMIRF.

The two health providers have warned that they will no longer accept patients from the Northern Marianas unless the Fund’s health insurance immediately pays its debt.

NMIRF is hoping that the Legislature would somehow provide the Funds so that the health insurance which has always been running in deficit, can settle its debt. In 1999, the health insurance paid an average of $400,000 monthly in medical bills which led the Fund to increase the employee’s health contribution by 50 percent in January this year.

Surprised at the huge amount of billing the Fund received from Straub, the health insurance examined the accounts for each patient only to discover discrepancies in the records.

According to Dolores S. Moore, manager for Group Health & Life Trust Fund, her office has already sent back $1 million worth of billings to Straub after an evaluation showed that the Fund should not pay such amount.

The Fund insists that the excess billing should be shouldered by the Medical Referral Program since the health insurance coverage has set a limit to its members based on the premium that they are paying.

Recognizing the complexity of managing the health insurance, the Fund is now set to hire a review utilization firm to check every billing submitted by the health provider, a task which it failed to do since it took over the job.