New law creates Commonwealth Medicaid Agency

Authored by Sen. Sixto Igisomar, the bill is now Public Law 21-28.

It aims to (a) recognize, establish and organize the Medicaid agency as an agency in the executive branch; (b) direct the agency to plan, design, implement, and operate Medicaid enterprise systems that include among others, the ability to efficiently and effectively process claims for Medicaid services and submit data to the Transformed Medicaid Statistical Information System or T-MSIS or replacement system as may be required; (c) establish a claims and clinical data warehouse, and promote health information exchange; and, (d) provide a community health record system that would enable beneficiaries to see their medical information.

Prior to the governor’s signing of P.L. 21-28, there was never a formally recognized and established Medicaid agency, Igisomar said.

Medicaid in the CNMI was originally established as a program under the authority of the Department of Public Health and Environmental Services in 1978.  With the passage of P.L. 16-51, which transformed the health department into the Commonwealth Healthcare Corp. in 2009, the Medicaid program was transferred to CHCC.

In 2011, however, Igisomar said the Centers for Medicare and Medicaid Services directed the separation of the Medicaid program from CHCC, “to prevent conflict of interest.” That same year, then-Gov. Benigno R. Fitial issued Executive Order 2011-16 to transfer the Medicaid program to the Office of the Governor.

The bill states that “there is a need to establish the Commonwealth Medicaid Agency and incorporate Chapter 140-30 of the CNMI Administrative Code in statute.”

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