Medical referral patients refused in Hawaii, Guam

The strained relationship between the Commonwealth and Queen’s Medical Center has affected patients who were sent off island for medical services since most Hawaii-based hospitals no longer honor the CNMI health card.

Aside from Queen’s, Straub Health Center also stopped accepting health cards from Northern Marianas unless accompanied by a request for an off-island treatment issued by the Medical Referral Office.

In addition, Group Health and Life Insurance Program subscribers are also being turned away by hospitals in Guam, making it doubly hard for subscribers to get the necessary medical attention immediately.

Legislators aired concern that these problems may prod health and life insurance subscribers to seek legal opinion due to inconvenience caused by unsettled debts incurred by GHLI Branch and the health department.

Last week, Sen. Pete Reyes, Sen. Thomas Villagomez, Health Secretary Kevin Villagomez and representatives from the Attorney General’s Office departed for Hawaii to iron out the problem which stemmed from insurmountable billing charges.

Queen’s had inquired over the delayed bi-weekly payments earlier arranged by the health secretary. The bi-weekly payment is pegged at $300,000.

House Committee on Health and Welfare chair Rep. Malua Peter said Mr. Villagomez should resolve the problem with Queen’s and reconcile billing statements that have already been paid, and the remaining medical charges that have to be settled.

Presently, the committee is reviewing records earlier requested from the GHLI to determine how the Legislature will be able to come up with a resolution to alleviate the agency’s funding problem.

Retirement Fund Board Chair Vicente Camacho has also admitted that medical centers abroad have lost confidence in the GHLIP due to the continued inability of the Commonwealth government to pay off-island health providers.

This is the same reason why NMIRF urged the Legislature to source out additional funding assistance in hopes to settle multi-million medical debts and restore the credibility of the Northern Marianas.

Mr. Camacho likewise urged the Senate to identify additional allocations to set up its utilization review board to assist patients on their off-island medical treatments.

He also said services of Hawaii Management Alliance Association are necessary at this point to enable GHLI subscribers to get necessary treatments without being asked to pay up front.

Once HMAA services are taken, GHLIP will be able to tap the services of the company’s pharmaceutical benefits manager and in-house doctors who will scrutinize medical billings.

Through this, GHLIP will be able to realize a savings of $1.2 million a year, the board chair pointed out. In addition, the agency does not need to hire a pharmacy who will scrupulously check prescribed drugs and save over $100,000 annually on salary and benefits alone.

“Our members deserve the best health care and we can deliver that with the Legislature’s help,” Mr. Camacho said in a letter to Sen. Ramon S. Guerrero.

He said an HMAA card which will be issued to GHLIP subscribers will guarantee that off-island medical referral patients will not be turned away by hospitals in Honolulu nor be forced to pay immediately even before treatments are rendered.

“We simply have no more credibility and this calls for prompt action in terms of finding $1 million to jumpstart the program. The benefits to be realized are far greater than the anticipated expense,” said Mr. Camacho.

The $1 million initial fund will take care the $400,000 trust fund under the joint ownership of HMAA and GHLIP as prescribed by the State of Hawaii while the $300,000 is needed to be established to pay for all claims that are coming in immediately after the transfer of GHLIP functions to HMAA. (EGA)