Fund: $30M old claims remain unprocessed
Some $30 million old claims for retirement health insurance remain unprocessed, according to the NMI Retirement Fund.
In a report to the Legislature, the Fund said these claims were made even prior to the entry of a third party administrator, Hawaii Pacific Medical Referral, in 2001.
These claims are both from on-island providers totaling $29,840,492 and off-island providers reaching $482,027.
Data showed that the Commonwealth Health Center has the biggest unprocessed claim totaling $28.6 million.
Other providers are PHI Pharmacy ($617,667), Marianas Eye Institute ($69,486), Queens Medical Center ($187,209), St. Francis Medical Center ($93,473), Guam Memorial Hospital ($89,429),Rehab Hospital of the Pacific (33,877), Kapiolani Medical Center ($24,773), Pacific Cardiology ($20,790), and Castle Medical Center ($1,228).
Further, the Fund said that it has some $6.2 million in unpaid medical claims by HPMR itself, whose contract with the agency expires next month.
In its report, the Fund said it needs to get appropriation to retire or liquidate old medical claim liabilities “to restore the credibility” of its Group Health and Life Insurance program.
The Fund told the Legislature Tuesday that it posts an average monthly shortfall of $436,064.
At the same time, its uncollected outstanding obligations from the CNMI government amounts to over $84.4 million.
The Fund reported that it disburses some $51.274 million to pay out various vendors and consumers. This include $39.2 million for retirement pensions; $3.7 million for survivor payments; $1.2 million for disability payments; $3.4 million for refunds of contributions, and a total cost of administrative operations that amount to $1.4 million.
Meantime, the CNMI government’s total outstanding obligation to the Fund reached $84.410 million, including $70.1 million in total employer share payments; $8.4 million due from Public Law 11-41; $1.4 million in total appropriations for FY2003; $780,733 in Trust Territory Prior Service costs; and $3.54 million representing the 30 percent bonus paid by the Fund.
The Fund said that it receives total funds of $46 million annually but it disburses $51.2 million on a yearly basis.
Further, the Fund cited a $70.1 million in outstanding employer contribution from the CNMI government and $9.8 million in outstanding annual appropriation.
