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Health care provider seeks $2-M from NMIRF
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Posted on Aug 10 2000
A Hawaii-based health care provider is demanding payment of over $2 million from the Northern Mariana Islands Retirement Fund to recover expenses it had spent for CNMI patients brought to the island state for medical treatment.
NMIRF Administrator Juan S. Torres said he was surprised to find out about the huge amount which the Fund reportedly owes the health care company.
A meeting is scheduled to be held between Gov. Pedro P. Tenorio, the Commonwealth Health Center and the Medical Referral Office to discuss the problem.
Mr. Torres said he wanted a detailed evaluation of individual billings to find out who among the people brought to Hawaii should be taken cared of by the NMIRF.
This problem could have been prevented if the Fund had hired a medical evaluator or a review utilization firm a long time ago, he said. The NMIRF board is set to hire a firm to carry out a review of the health claims of all its members to prevent over billings.
The board has been evaluating offers made by firms that will be able to negotiate the best quality service and cost for the Fund, which has been having difficulty coping with the huge cost of medical claims since it took over the government’s health insurance.
A Hawaii health insurance firm has offered to provide the Fund 20 percent discount on all medical services including room and board, surgery and prescription drugs for patients.
Moylan’s Insurance has likewise presented its own service package during the last board meeting.
In 1999, the Fund spent an average of $400,000 a month in health claims of its members alone.
The skyrocketing cost of medical expenses had forced the CNMI Group Health Insurance Program to increase by 50 percent the premium contribution of its more than 5,000 members last Jan. 1, 2000. Mr. Torres said the hike in employee’s premium contribution has helped in slowly easing the huge deficit on the health claims.
