NMIRF seeks $6-M funding to settle government’s unpaid bills

The Northern Mariana Islands Retirement Fund is seeking a $6 million funding from the Legislature to wipe out the outstanding debt of the government’s health insurance program and hire a review utilization firm.

Health providers from the U.S. mainland and Hawaii have demanded $5 million to settle the unpaid billings of the government health insurance, according to Vicente Camacho, board chair of the NMIRF.

But the release of funding from the Legislature is dependent on the hiring of a review utilization firm by the Fund.

Mr. Camacho said the Fund met with House Committee Chair Malua Peter a week ago where they discussed the immediate need for the money so that the government health insurance can settle its obligations to various health providers.

Operation of the government health and life Insurance was turned over to NMIRF in June 1996 without providing any funding, which left the Fund without any choice but to settle its liabilities.

“You have to remember when they created this (government health insurance) they did not profit. No financial genius can manage this without enough funding,” Mr. Camacho said.

During the meeting, Rep. Peter made it clear that she wants a review utilization firm hired first by the Fund to examine the billings before the Legislature can release any money.

The board has approved the hiring of Hawaii Management Alliance Association (HMAA) to provide utilization review services and eventually pave the way for the privatization of the government health insurance.

Mr. Camacho said hiring HMAA will result in $1 million savings for the Fund. The Honolulu-based company will get at least 20 to 50 percent discount, depending on which hospital the members will be referred. The company has in-house doctors who will analyze the billing and a pharmaceutical benefits manager who monitors the prices of medicines.

In return, HMAA will get 10 percent of the paid claims for every billing they will look into.

HMAA operation

The board would need $1 million so that HMAA can begin operation. Such amount would be used to establish a $300,000 revolving account, a $450,000 trust fund and pay the $25,000 setup fee for the computers as soon as the contract with HMAA is signed.

“These are professionals, they know what they are doing so I hope the Legislature gives us the money right away,” Mr. Camacho said.

Mr. Camacho has expressed hopes that the Legislature will provide the needed funding immediately so that HMAA can begin work by January next year.

The terms and conditions of the agreement with HMAA are still being worked out by the board. HMAA said it is willing to help look into previous billings of the health insurance for a nominal fee.

HMAA, through Hawaii Western Management Group, provides the Pacific Islands Program with the Third Party Administration services. They ensure timely payment of claims, provide expanded network including Hawaii, the Continental USA, Guam and the Philippines, as well as coordinate all aspects of care for patients and their family members.