By Emmanuel T. Erediano
[email protected]
Variety News Staff
BESIDES a reliable and sustainable funding mechanism for the Health Network Program, the Commonwealth Healthcare Corp. is also recommending that the CNMI government ensure full implementation of Medicaid coverage and reimbursements for referral-related logistical costs.
These include the establishment of billing protocols, documentation standards, and claims-processing workflows between CHCC and the Commonwealth Medicaid Agency to ensure that eligible HNP expenditures are recovered through federal matching rather than absorbed by CHCC’s budget.
These are among the recommendations outlined in the analysis that CHCC Chief Executive Officer Dr. Esther L. Muna, PhD, MHA, FACHE, submitted to Gov. David M. Apatang and the Legislature.
CHCC also pushed for timely action to advance the foreign hospital State Plan Amendment to the governor for approval.
States or U.S. territories are required to send SPAs to the Centers for Medicare & Medicaid Services for approval when they plan to make a change to program policies or operational approaches, according to the Medicaid website. CHCC said timely legislative and administrative action is a critical step that will enable the CNMI to expand referral options, reduce costs, and improve access to care through qualified international providers.
CHCC also recommended the expansion of on-island specialty services to reduce long-term reliance on off-island medical referrals. The healthcare corporation also urged the CNMI government to strengthen and diversify referral partnerships across the region, within the continental U.S., and internationally to enhance access, reduce costs, and ensure continuity of care.
CHCC also urged the administration and the Legislature to advocate for the extension or permanent authorization of the CNMI-Only Transitional Worker, or CW-1, and H-1B cap exemption programs essential to CHCC’s healthcare workforce recruitment pipeline, recognizing that the scheduled end of the CW program in 2029 directly threatens CHCC’s ability to retain specialty providers whose on-island presence reduces the number of medical referrals and costs.
