(CMA) — The Commonwealth Medicaid Agency, through the support of the Apatang administration, continues to lead with innovation and purpose by formally implementing telemedicine and telehealth services as covered delivery methods under the CNMI Medicaid State Plan, through Administrative Directive CMA2025-052, effective Jan. 20, 2026.
This milestone policy reflects CMA’s proactive commitment to expanding access to care, strengthening provider capacity, and improving health outcomes — especially for Rota and Tinian residents, where geographic barriers have long limited timely access to medical services.
Why telehealth matters
Telemedicine has become a nationally recognized solution to improve access, reduce delays in care, and support continuity of treatment. Organizations such as the American Telemedicine Association have emphasized that telehealth improves access to specialty care, enhances patient engagement, and delivers outcomes comparable to in-person visits when used appropriately. National healthcare leaders consistently note that telehealth is particularly impactful in rural and island communities, where distance and provider shortages create systemic barriers to care.
The National Association of Medicaid Directors has similarly highlighted telehealth as a key tool for Medicaid programs to increase access, improve equity, and modernize service delivery without compromising quality or accountability.
How the policy works
Under CMA’s directive, telemedicine is recognized as a method of delivering covered Medicaid services — not a separate benefit. CMA-enrolled providers may deliver covered services via telehealth when services are safe, clinically appropriate, and compliant with federal and local requirements. Reimbursement will be equivalent to in-person services unless otherwise approved through a CMS-approved State Plan Amendment.
The policy allows for:
• Real-time video telehealth services;
• Audio-only services, when clinically appropriate and technology is limited;
• On-island and off-island specialty consultations coordinated with local primary care providers.
A commitment to equity and access
“Telehealth is not about replacing in-person care — it’s about reaching people who otherwise might go without care,” said George Cruz, the CMA director. “For families on Rota and Tinian, telemedicine can mean the difference between waiting weeks or months for care or being seen and treated when it matters most.”
Cruz emphasized that advancing technology is essential to meeting the CNMI’s healthcare needs.
“We must modernize how care is delivered if we want better outcomes,” Cruz said. “This directive is about equity, access, and dignity — making sure every Medicaid beneficiary, no matter which island they live on, has a real pathway to quality healthcare.”
Short- and long-term benefits
In the short term, telehealth expands access to consultations, follow-up visits, behavioral health services, and specialty care — reducing travel burdens, missed appointments, and delays in treatment. Over the long term, it strengthens preventive care, supports chronic disease management, and builds a more resilient and responsive healthcare system for the Commonwealth.
“As part of our long-term telehealth vision, we hope to add additional covered services as part of the telehealth delivery method,” Cruz said.
“This is just the beginning,” Cruz added. “CMA is committed to continuing this work through thoughtful planning, technology investments, and future State Plan Amendments to ensure telehealth remains a strong and permanent part of our healthcare delivery system.”
Building the future of healthcare in the CNMI
By embracing telemedicine, CMA is aligning the CNMI Medicaid Program with national best practices while tailoring solutions to the unique needs of island communities. This directive represents a meaningful step toward a healthier, more connected, and more equitable future for all CNMI residents.
For more information, providers and beneficiaries may contact the CMA at (670) 664-4880, email info@cnmimedicaid.org, or visit www.cnmimedicaid.org/.
