CNMI loses credibility to health providers abroad

Due to continued inability of the Commonwealth government to pay off-island health providers, medical centers abroad has lost confidence to government-operated Group Health and Life Insurance Program and has refused to accommodate program subscribers.

Citing this reason, NMI Retirement Fund officials reiterated its call for funding assistance to the Legislature in hopes to settle multi-million medical debts and restore the credibility of the CNMI.

Board Chair Vicente C. Camacho likewise urged the Senate to source out additional funding allocations to set up its utilization review board to assist patients on their off-island medical treatments.

Further, Mr. Camacho said the 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 or more, 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 forced to pay immediately even before treatments are rendered.

“WE simply have no more credibility and this is more the reason to facilitate finding $1 million to jump start the program. The benefits to be realized are far greater than the anticipated expense,” said the board chair.

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.

The Hawaii-based review firm has more than 26,000 members and has the negotiating power to get reduced rates from major medical providers in Honolulu such as Queen’s Medical Center and Straub Health and Clinic.

NMIRF officials believe that once the services of the review firm is tapped, GHLIP will have lesser problems and better benefits.

Even the Office of Public Auditor earlier recommended to GHLIP the hiring of the review firm to prevent overblown medical charges and unnecessary medical services billed to GHLIP. (EGA)