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Medicaid: No use of Medicaid to private clinics
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Posted on Jul 02 2015
Private clinics on island can no longer accept Medicaid clients since the Commonwealth Healthcare Corp. has made a final decision not to extend the use of private practitioners for outpatient services provided to adults and children.
CNMI Medicaid Office program administrator Helen Sablan said that there is no extension for the private clinics.
“It ended yesterday (June 30), CHCC chief executive officer Esther Muna will try and see for a month. She will let me know within a month if we need to open up again with the private clinics,” Sablan said in an email to Saipan Tribune yesterday.
There are three main clinics that accept Medicaid patients—Saipan Health Clinic, Pacific Medical Center, and Marianas Medical Center.
If and when Muna makes the certification, she will be certifying whether the hospital does not have the physicians to treat patients.
As of now CHCC has 33 physicians and won’t need the assistance for outpatient services from private clinics.
In a separate interview, Muna confirmed that they will not extend Medicaid to private clinics.
“CHCC will not be certifying that there is a shortage of providers at CHCC. CHCC, however, will be monitoring the census and purpose of visits of the patients to ensure that access to care is available,” Muna said.
The revised state plan, which has been approved by the U.S Department of Health and Human Services Region 9, requires Medicaid patients to first seek treatment at CHCC and does not allow private clinics to provide services to Medicaid beneficiaries unless CHCC is not able to accommodate the patients.
The whole purpose of the state plan was to help the Medicaid program meet its financial goals because they had a cash flow issue in 2012.
