‘Public will be given chance to talk’

Commonwealth Healthcare Corp. board chair Lauri Ogumorro, left, and legal counsel Nancy Gottfried listen to speakers at the CHCC board meeting held last Friday at the Commonwealth Health Center. (Bea Cabrera)

The CNMI community will be given a chance to comment about the increase in board and room rates at the Commonwealth Health Center.

CHCC board chair Lauri Ogumoro said Friday there will be a time for the public to comment as there is a process and a venue that needs to be followed under the law.

In the meantime, the legality of the rate increase stays.

CHCC counsel Nancy Gottfried pointed out that CHCC was not remiss in its duties in following the process as provided by the Administrative Procedure Act.

She said that Gov. Ralph DLG Torres has already approved the emergency regulations that provided for the increases. He signed the English translations on Oct.3 and the indigenous language translations on Oct. 4.

“Emergency regulations go into effect as soon as the governor signs it,” Gottfried said. “These emergency regulations take effect upon the signature of the governor and are good for 120 days.

“At the same time, we did a notice of intent to promulgate as permanent these rate changes,” she added.

Gottfried pointed out that room and board increases are getting the most media attention but Health and Vital Statistics Office fees and Dental Clinic fees also went up.

“In the Oct. 28 Commonwealth Register, the emergency regulations and intent to promulgate as permanent the same regulations will be published and there will be a 30-day notice and comment period for the public,” she added.

To access the Commonwealth Register, go to cnmilaw.org, the Law Revision Commission website.

One can also Google “Commonwealth Register CNMI.”

The CHCC emergency regulations can be found on the last registered number 39 or 40 and then you go to the last volume, click 10 for October, and then send your comments via email to Commonwealth Healthcare Corp. CEO Esther Muña as the address is provided.

“If anyone wants electronic copies of this, they can call CHCC and ask Janet or Bernie to have the notice of intent to promulgate as permanent regulations emailed to them. If people want to pay for a photocopy, we can do it for them,” she added.

The CHCC board still managed to entertain two people during the board meeting when they opened the public comment part of the meeting.

A certain Mr. Atalig, a private citizen, disagreed with the rate increases.

“I feel the decision was made certainly without justifiable basis, insufficient facts, and most of all disingenuous. I don’t know if there has been any report of study made regarding the need to increase the rates of the hospital. But I am here to express my opinion as the increase was truly arbitrary, capricious, and ultimately will affect the public.”

He also said the public and Legislature must be given a chance to review the new rates.

“I strongly feel that the Legislature should also have an input on this. …They should give us a time to review and comment,” he added.

Reading from a letter written by the company’s plan administrator Frank J. Campillo, Calvo’s Select Care account executive Marcia Chieko Calvo stated that Select Care has several concerns about the rate increases:

-Normally, the unit costs and utilization vary geographically from one health plan to another depending on the availability and leverage of the insurer to negotiate fees to health providers. In the CNMI, the significant part of the delivery of medical services are concentrated within CHCC and any increase in fees dramatically and directly affect premium rates since there is no leverage to access other providers;

-Health plans will have to pass the increase to the consumers because with medical trend rising fast in the CNMI, Select Care anticipates an increase in its premium rates;

-Health plan providers and the community should be given at least three months’ notice for any proposed rate increase; and

-Suggests that CHCC implement more reasonable adjustments so as not to shock the healthcare system.

The letter ended that they look forward to Muña’s willingness to work with insurance providers and negotiate fees and terms.

Ogumoro thanked the community for their comments and encouraged them to go to the Register.

Responding to Atalig’s question if the hospital does not have money, Ogumorro said, “Yes.”

“The hospital needs support from the Legislature—the financial support that we are not getting. So therefore, we as a corporation, have to make ends meet. If we don’t get help from the Legislature, you can well imagine our concern,” she said.

For the just finished fiscal year, CHCC had asked for a budget of $22 million—$16 million for indigent care from the CNMI government and $6.2 million from the federal government through Medicaid. Instead, the CNMI government allotted a budget of just $825,299 to CHCC.

Gottfried said the Legislature is not involved in the rulemaking process of CHCC and that the only input by the Legislature are to nominate board members and hold confirmation hearings for these nominees.

“The Legislature is involved to the extent that it was the Legislature that passed the statute which instituted the board.”

“The only way to challenge this is through a court of law. The Administrative Procedures Act is a rulemaking process and the Legislature is just not involved,” she added.

Atalig mentioned that the Legislature is scheduled to hold an oversight hearing regarding CHCC’s rate increases.

According to Ogumoro, the board will have to wait and see what happens.

“We don’t know what the outcome will be at this point. But we would welcome an oversight hearing and so we can talk to them about their oversight to us,” she added.