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Staywell service for Manila patients continues
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Posted on Dec 01 2005
Staywell Insurance will continue to provide services for CNMI referral patients in Manila, following the NMI Fund’s decision to extend up to 12 months the third party administration contract of Hawaii Pacific Medical Referral.
HPMR, which subcontracts Staywell for Manila patients, earlier said that it would terminate its partnership with Staywell by Dec. 1 if a longer extension period was not secured.
“Effective Dec. 1, 2005, we are terminating our arrangement with Staywell for access to their Philippine providers. This will allow us time to process and pay all claims from the Philippines prior to Dec. 31, 2005,” said HPMR vice president and chief operating officer Thomas G. Cannon.
“Of course, if there is an extension of the agreement, all our actions to close down operations will cease,” Cannon said in a Nov. 19 letter to Fund administrator Karl T. Reyes.
HPMR’s extended contract would expire on Dec. 31, but following a negotiation with the Fund board last week, the company is assured of up to one-year extension.
Yesterday, Reyes said that a new extension agreement with HPMR was up for approval by both parties.
“It means that Staywell service in the Philippines continues. Although, we’re not party to their agreement, the extension of our contract also extends HPMR’s partnership with Staywell,” said Reyes.
The new extension agreement would call for a 90-day termination clause, giving both parties enough time to do transition work.
The Fund had entered into a three-year contract with HPMR in 2001.
During this period, HPMR said that it saved the CNMI government over $8 million through discounts and settled ineligible charges.
Meantime, during the extension period, the Fund is expected to negotiate with potential third party administrators.
The Fund will soon issue an RFP to seek a TPA.
HPMR will remain the Fund’s third party administrator until a better TPA is found.
The Fund is advised to continue with a TPA rather than pursue privatization of the government’s group health insurance.
The government’s negotiating team recently rejected the proposal of SelectCare to privatize the program due to high rates.
