GHLITF transfer to governor’s office eyed

Group Health and Life Insurance officials are asking the Legislature to study possible transfer of GHLI Trust Fund to the purview of the Office of the Governor in hopes to get the necessary assistance to resolve problems plaguing the program.

In a letter to Committee on Health and Welfare Chair Maria Peter, GHLITF Manager Dolores Moore said the committee should begin exploring the possibility of appropriately placing GHLITF under the responsibility of the Governor’s Office.

The transfer will enable the program to be more efficient in addressing the issues that have continuously plagued it, Ms. Moore explained.

The program manager further explained that presently GHLITF is in dire need of an updated actuarial study to enable the program to alight its fee schedule more accurately.

By aligning fee schedule more accurately, it will cover actual medical costs in the CNMI, Guam, Hawaii, and the US Mainland, she pointed out.

The actuarial study will also serve as a benchmark in developing institutional partnership like managed healthcare system with private and public health providers in the Commonwealth.

Besides, the possible partnership with private and public health providers will result in facilitating institutional discounts, timely reconciliation of billing system, and streamlining billing and payment processing.

“This will reduce medical institutional costs and GHLITF’s administrative overhead, in addition to better internal control in the usage of utilization review staff,” the program manager emphasized.

Earlier, the GHLIP disclosed that since the inception of the Trust Fund, the resources of the program have not been adequate to pay all medical claims of GHLI subscribers.

In fact, Ms. Moore said even these claims are processed by the GHLIB, the Trust Fund accounting division could not disburse payments to vendors due to continued funding shortfall.

“Our office will provide the committee information on a monthly basis or quarterly basis, so that future claims will be processed timely, and more importantly to pay the providers promptly,” she said.

The GHLIP based on the recent itemized cost breakdown released, is in need of over $4 million funding assistance from the Legislature to settle medical bills on more than 295 off and on island health service providers. (EGA)