‘Medicaid will remain with Executive Branch’

The operation of the Medicaid program will remain with the Executive Branch, according to Gov. Benigno R. Fitial, who disclosed Wednesday that he is now exploring ways on how the existing cap and matching requirements could be removed.

Medicaid is a federal/state program administered by the states and funded by both federal and state revenues through 50-50 matching funds.

The annual federal cap for the CNMI is $5 million, which requires an equal amount from the CNMI government. Any expense in excess of $10 million is shouldered by the CNMI. To date, this program has 18,000 beneficiaries.

Fitial disclosed during a visit to the Commonwealth Health Center Wednesday that his administration is in constant talks with Commonwealth Healthcare Corp. CEO Juan N. Babauta on how to remove the federal cap.

Babauta said that CNMI will explore a federal law where the Commonwealth may qualify for critical access, thus removing the federal cap or matching requirements. However, Babauta said there are challenges that they will have to face, including justifying CHC as a “rural hospital.”

“If we can qualify under that designation, they can provide us 100 percent reimbursement on Medicaid, which means no cap and no matching funds. But we have to go through a process and this where the governor plays an important role because of his personal relationship with federal officials [in Region 9],” said Babauta.

“The designation [of rural hospital] is the best option for us,” added Fitial.

Fitial and Babauta will participate in the regional conference with federal agencies on March 1-2, 2012, of which this item will be among the agenda.

Babauta earlier urged the Legislature to conduct a thorough oversight on the Medicaid program because it continues to certify eligible recipients even without enough funds. This results in a big shortfall for the corporation and the government.

CNMI Delegate Gregorio Kilili C. Sablan earlier said the $5 million cap for Medicaid has already been removed and the reimbursement ratio has been changed. From just $40 million from 2011 to 2019, the CNMI is now eligible for $140 million during that same period, Sablan said. The CNMI expects to get this fiscal year $18.233 million in Medicaid grants, he added.