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Tuesday, April 22, 2014

Health insurance firms assured of discounted rate on new CHC fees

The long wait of health insurance companies in their appeal for discounts on the new and higher rates at the Commonwealth Healthcare Corp. will apparently soon be over.

Corporation CEO Juan N. Babauta told Saipan Tribune yesterday that health insurance firms will soon be given discounted rates on the new hospital’s fees.

Babauta, however, could not immediately state the percentage amount of the discount.

The corporation increased hospital fees and services in August 2012 by as much as 300 percent.

Insurance firms described the new rates as significantly higher than that of Guam and other states. They said these high rates will lead to higher health insurance premiums, which will result in more people becoming uninsured.

The health insurance carriers, in a request to the corporation in September, recommended replacing the announced fee increases with a 20-percent across-the-board hike and plan for small adjustments in future years, based on true hospital rate setting calculations. In the alternative, they want a 50-percent discount on the rates.

The corporation has yet to formally respond to these appeals.

Since October, the corporation has been working with insurance firms for a new provider agreement that will integrate the new fees. Due to this yet-to-be-settled agreement, some claims remain pending.

“The decision will be finalized this week. We have to get back to the insurance companies to discuss some specifics such as the effectivity date and the [discount] percentage,” said Babauta yesterday.

He hinted, however, that it would be impossible to comply with their request of a 50-percent discount.

Saipan Tribune learned that insurance companies asked the corporation to implement the new rates starting January 2013 and not August 2012. They also asked for consideration on other “specific rates” included in the new charge master.

The new fees will not affect government programs such as Medicare or Medicaid and will only impact people who are insured through private payers.

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