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Monday, April 21, 2014

Corporation OK’s 10-pct. discount for health insurance companies

Health insurance companies doing business with the public hospital were approved a mere 10-percent discount on the new fees enforced at the Commonwealth Health Center.

Commonwealth Healthcare Corp. interim CEO Esther Muña disclosed to Saipan Tribune that health insurance firms will be given a 10-percent discount rate on new fees—far from the firms’ proposal of a 50-percent discount.

Insurance companies had proposed the 50-pcercent discount if the corporation pushes through with its decision to increase by up to 300 percent the cost of services and fees at CHC.

The new provider agreement with each insurance company, Muña said, is effective Jan. 1, 2013. This means insurance firms will be assessed these new fees—with 10 percent discount—in January 2013 instead of August 2012 when the emergency regulation took effect.

“We have a new agreement with them … and it takes effect Jan. 1, 2013,” she said, adding that the discounted rate was approved to help health insurance firms cover the new hospital fees.

The corporation implemented in August 2012 an emergency regulation that increased hospital fees and services by up to 300 percent. Insurance firms earlier described these new rates as significantly higher than Guam and other states.

According to the health insurance companies, these high rates will lead to higher health insurance premiums, resulting in an increased number of uninsured individuals.

In September last year, health insurance carriers formally asked to the corporation to immediately replace the announced fee increased with a 20-percent across the board increase and plan for minimal adjustments in future years based on true hospital rate setting calculations, or 50 percent discount to health insurance carriers as alternatives. They also request consideration on other “specific rates” included in the new charge master.

Staywell Saipan Inc. branch manager Eric Plinske told Saipan Tribune that since the contract is in the process of being finalized, he declines to give a statement at this time. He described the “provider agreement” as a comprehensive document that would detail the specifics of each and every transaction to be made with the hospital.

Also deferring his comments on the issue at this time is Calvo’s Insurance Underwriters Inc. branch manager Eli Buenaventura.

In an earlier interview with Saipan Tribune, top officials of insurance companies said that the “excessive” rate hikes in hospital fees will mean passing the added cost to their members, which will translate to an average of 25 to 30 percent increase in premium charges. This may also force these companies to re-evaluate the policies they offer CNMI customers.

Among the health insurance firms doing business with the corporation are Calvo’s Select Care, Moylan’s NetCare, Staywell, and TakeCare.

The new fees at the CHC will not affect government programs such as Medicare or Medicaid and will only impact the population insured through private payers.

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