Guam’s Calvo urged to consider changes to Medicaid processing

WASHINGTON, D.C.-Guam Delegate Madeleine Z. Bordallo has asked Gov. Ed Calvo to consider changes to the Medicaid program in Guam that may allow the Department of Public Health and Social Services to provide Medicaid coverage for emergency medical treatment for otherwise eligible migrants from the Freely Associated States.

According to the Center for Medicare and Medicaid Services (CMS), more than $4.5 million in federal Medicaid funds available to Guam between fiscal years 2009 and 2011 were left unspent. These excess funds were the result of increases in Guam’s Medicaid cap secured by Bordallo within the American Recovery and Reinvestment Act. The Affordable Care Act included a provision offered by Bordallo that increased Guam’s Medicaid cap from $13.7 million in 2010, to $24 million in 2011, to $42 million in 2012. This cap will continue to increase to $58 million in F2019, nearly tripling federal Medicaid dollars available to Guam.

In her May 15, 2012, letter to Calvo, Bordallo noted that DPHSS has not filed any Medicaid claims for emergency services provided to otherwise eligible Compact migrants, and instead provides coverage for these services through the locally-funded Medically Indigent Program. She noted that medically necessary dialysis treatment qualifies as an emergency service under CMS regulations, one of the primary health care costs for Compact migrants on Guam. Shifting coverage for these services from MIP to Medicaid would make the federal government responsible for meeting 55 percent of the cost and realizing significant savings in Guam’s local health care dollars.

Bordallo also sent a letter to Assistant Secretary Babauta of the Department of the Interior to request his assistance in clarifying the specific circumstances under which Compact migrants would be eligible for emergency Medicaid coverage.

“For far too long, our island has been responsible for bearing the financial burden of providing healthcare to Compact migrants. Increases in Guam’s Medicaid cap have made it possible to shift some of that burden back to the federal government where it belongs. However, without changes to Guam’s Medicaid program, our local government will continue to carry the majority of this burden unnecessarily,” said Bordallo.

“Recent attempts in the House to cut critical Medicaid funding for the territories demonstrate the need for our local leaders to work together to make the most of federal funds available to our island. I am working with Governor Calvo and Secretary Babauta to find a way to better target the spending of our Medicaid funds on Guam so that they go further within our community and mitigate the financial burden of providing medical coverage for migrants from the Freely Associated States.” (PR)