DPH to ask off-island patients to secure MRO authorization

Unless armed with treatment authorization from the Medical Referral Office, patients seeking off-island treatment will be obliged to pay upfront to get medical services from Hawaii-based hospitals.

Without the treatment authorization to present before Queen’s Medical Center, Straub Health and Clinic and St. Francis Clinic, CNMI patients seeking medical services will be charged as self-paid.

Health Secretary Kevin Villagomez yesterday disclosed the required treatment authorization was one of the agreement reached with the Hawaii hospitals to prevent undue medical charges billed to the Medical Referral Office.

With the authorization, off-island patients will be considered legitimate medical referral patients and billing charges will be automatically coursed through the health center.

The arrangement is part of the DPH efforts to track down CNMI patients seeking treatments abroad under the medical referral programs. Through this, the health department is confident that only legitimate patients will be rendered medical services and the program will only pay correct medical billings.

In addition to this, DPH also agreed to be the gatekeeper of these off-island medical bills of authorized medical referral patients. This is also part of the agreement recently reached between Hawaii hospitals and the DPH.

Earlier, Senate Floor Leader Peter Reyes said Queen’s management has made a firm commitment to the Commonwealth that it will be accepting CNMI patients again following a lengthy discussion on alleged billing discrepancies.

Presently, CNMI has an estimated $870,000 outstanding debts to Queen’s but Mr. Reyes disclosed that measures will be undertaken to channel necessary funds to pay the Honolulu-based hospital.

Another problem that the Commonwealth has discovered during the trip, said Mr. Reyes, is the inclusion of patients from Marshall Islands and Palau in the CNMI bills.

Meanwhile, House Committee on Health and Welfare Chair Malua Peter disclosed a meeting with NMI Retirement Fund Administrator Juan S. Torres and GHLIP Manager Dolores Moore will be scheduled.

Ms. Peter said through this meeting, the committee hopes to get a clearer picture of the current standing of the program following the review of documents submitted by the GHLIP.

She said review of the documents are now on the final stage and will be forwarded to Health and Welfare committee for comprehensive discussion.

Based on the updated status report for the Medicaid Agency, off-island medical referral patients only incurred an estimated $18,978.81 to-date but hospital staff continue to turn away off-island medical referral patients.

Since October last year, almost $1.711 million worth of medical bills were settled to the Hawaii hospital but billings continue to pile up.

In October last year, the Medical Referral Office earlier settled GHLI financial problem with Queen’s amounting to over $1.4 million while Medicaid Agency paid an estimated $338,044 and other medical bills of $56,644. (EGA)