Private health providers eyed to handle GHLI

Posted on Jan 08 2001

Legislators will ask members of the Health Commission for suggestions on how to resolve the unpaid debt of the Government Health Insurance as they raised the possibility of allowing a private health provider to handle the program temporarily.

Rep. Malua Peter, chair of the House Committee on Health and Welfare, has expressed concern on the liability which the government will face in case of a possible lawsuit from a GHLI member.

Since last year, members of the government health insurance are turned away by health providers in Hawaii due to non-payment of debt of the GHLI.

While there have been previous meetings with legislators and Northern Mariana Islands Retirement Fund, the agency now managing the health insurance, officials have yet to identify the source of funds which will be used to pay the debt.

Representatives from the Office of Management and Budget, Department of Finance and Public Health met with Rep. Peter last week to discuss ways on how to settle the debt with the health providers as soon as possible before it turns into a medical disaster for the CNMI.

Straub Clinic & Hospital has demanded payment of $2 million for an undetermined number of years from GHLI while Queen’s Medical Center has asked for $1.8 million settlement of unpaid accounts.

Operation of GHLI was turned over to NMIRF in June 1996 without providing any funding which left the Fund without any choice but to settle some of its liabilities.

The NMIRF board has approved the hiring of HMAA to provide utilization review services and eventually pave the way for the privatization of the government health insurance.

Board Chair Vicente Camacho said hiring of HMAA which will result in $1 million savings to the Fund. The Honolulu-based company will get at least 20 to 50 percent discount, depending on which hospital the members will be going. The company has in-house doctors who will analyze the billing and a pharmaceutical benefits manager who keeps track on whether the charges for medicine are too high.

Members of GHLI who have gone to Hawaii for medical check-up have been turned away by the hospitals due to non-payment of debt of the government health insurance.

Rep. Peter said delay in the payment of Straub Clinic & Hospital and Queens Medical Center has made it difficult for members of the government health insurance to seek medical treatment in these institutions. (LFR)

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