Babauta OKs medical referral escort bill

Gov. Juan N. Babauta has approved a bill that provides for the expenses of medical referral escorts but he expressed a number of concerns, including the legislation’s lack of funding source.

The governor, in a transmittal letter to the Legislature, said that Senate Bill 14-82, which seeks to fund the travel and accommodation of escorts who accompany patients for off-island medical referral, would ensure that patients “can be cared for and assisted by a family member of friend.”

“This ensures that our families and loved ones are not left alone while undergoing medical treatment,” said Babauta.

The new legislation, authored by Sen. Joseph Mendiola, provides that the government shall pay for the expenses of a family member or a friend to escort patients that are sent off-island for treatment. These expenses include “the lowest cost for roundtrip airfare, reasonable accommodations, daily ground transportation at the set government rate, and a daily subsistence allowance not to exceed $30.”

Babauta, however, noted that the measure “is an unfunded liability” that would require funds dedicated for other health care programs.

He also said the measure only refers to the medical condition of the patient “prior to the actual travel for medical treatment.”

“Accordingly, an individual who does not qualify for an escort prior to the medical treatment would not be able to have an escort even if the medical treatment to be received will result in the need for an escort,” he said.

For instance, a patient undergoing an eye surgery may not need an escort to travel but would need it during the recovery period.

Further, the governor said the measure does not say who makes the determination if a patient escort is necessary, as required by the Medical Referral Committee.

He said the legislation should be amended to make it clear that the Medical Referral Committee, comprised of medical professionals, should make the determination regarding the need or safety of patients for off-island treatment.

The existing regulation requires that the program pay for the escort’s airfare only if the patient is indigent under historical federal poverty standards, although the patient’s airfare is paid regardless of income or assets.

The legislation, Babauta said, would “allow individuals earning a substantial income to travel at the cost of the CNMI government.”

More, the governor said that while the present program requires the escort to share the room with the patient, the legislation may be construed as providing the escort and patient separate rooms.

Further, the chief executive said the statute seems to allow the per diem for escorts regardless of the purpose of the transportation and without regard to what was actually expended.

The existing regulation, he said, only pays for documented expenses of ground transportation to and from the medical facility and medical appointments.

Babauta also feared that the use of the term, “entitlement” without regard to available appropriations, or other considerations now built into the existing regulations “increases the likelihood of litigation on at least some medical referral matters.”

He cited that the Government Liability Act provides for immunity from suit for failure to make or denial of a medical referral.

Mendiola’s bill became Public Law 14-64.