THE House Committees on Health and Welfare and Ways and Means on Tuesday wrote Gov. Ralph DLG Torres a joint letter regarding the CNMI Medicaid Agency’s “pressing need” for $5 million in reimbursement and administrative funds for fiscal year 2022.
Acting Medicaid Director Vicenta Borja said the amount is needed to fund the local match for the federal monies Medicaid received for FY 2022.
Borja told the Health and Welfare Committee last week that if the CNMI government fails to provide the $5 million in local matching, “we will have to sacrifice the $28 million that was appropriated to us — it does not roll over, so it will be returned to [the] federal [government.]”
In their joint letter to the governor Tuesday, Health and Welfare Committee Chair Tina Sablan and Ways and Means Committee Chair Donald Manglona urged the governor to consider taking the following actions:
1) Exercise your 25% reprogramming authority under the Planning and Budgeting Act or 1CMC § 7402(b) to immediately transfer the required funds to the CMA; and/or
2) Direct the secretary of Finance to expeditiously provide the House of Representatives with an updated status of all accounts to assist us in identifying the funding sources for an amendment to Public Law 22-08, the Annual Appropriations Act for FY 2022.
‘Catastrophic consequences’
Medicaid officials explained that American Rescue Plan Act funding cannot be used to meet the local matching requirement for Medicaid as previously believed, pursuant to a rule issued by the U.S. Treasury Department (87 FR 4338, the Final Rule implementing Coronavirus State and Local Fiscal Recovery Funds, codified at 31 CFR 35).
As a result, if approximately $5 million for the local match is not identified and remitted in this current fiscal year, the Commonwealth will have to return an estimated $28 million to the federal government.
The lawmakers told the governor that “the consequences of losing $28 million in Medicaid funding will be catastrophic for Marianas residents.”
The Medicaid Agency will have to shut down critical services and suspend payments to providers and vendors. The Commonwealth Healthcare Corporation will then be the only healthcare provider available to Medicaid patients, and it “will further strain CHCC’s medical staff and resources exacerbating already long wait times for appointments.”
Borja informed the Health and Welfare Committee that there are about 24,000 people availing themselves of Medicaid through presumptive eligibility.
If the CNMI government fails to fund the local matching for Medicaid, Sablan and Manglona said, these people “may be prematurely disenrolled even before the national public health emergency ends, and this is expected to drive up the cost of uncompensated care for CHCC.”
Borja said, “The people who will be hurt the most and most immediately will be patients in need of medical referral, whose access to off-island care will be disrupted. Relationships with off-island providers may also be jeopardized and will be difficult to rebuild.”
“Governor, the urgency of this matter demands swift resolution,” Sablan and Manglona said. “The ripple effects of losing $28 million in Medicaid money will be devastating, and the Commonwealth cannot afford to fail to find the $5 million needed to maximize federal allotments. We have proposed two possible courses of action to address the local funding needs of the Commonwealth Medicaid Agency and to protect the interests of the 38,000 residents now enrolled in Medicaid. There may be other potential solutions. We are ready to assist in our capacities as Chairs of the Ways and Means Committee and the Health and Welfare Committee and as members of the House leadership.”
