July 5, 2025

Alleged ‘excesses’ in private providers’ Medicaid bills

Finance Secretary Larrisa Larson told senators on Monday that the administration has discovered “excesses” in the Medicaid billing of private providers in the CNMI, prompting the Senate Committee on Health and Welfare to dig deeper into this and other Medicaid issues that have recently made the news such as non-payment to providers, proposed benefit cuts and local-federal funding requirements.

Committee chair Sen. Ralph Torres (R-Saipan) said yesterday it was the first time that the Senate was officially informed by the administration of “over-billings” by some private providers at a time when patients are now being asked to pay for their medications after some private clinics and pharmacies stopped honoring Medicaid insurance.

Torres asked CNMI Medicaid Office administrator Helen Sablan yesterday to attend a Thursday meeting with the Senate committee along with Finance Secretary Larrisa Larson at 2pm.

The committee also asked Sablan to provide documents showing the breakdown of the government’s unpaid Medicaid obligations to “all” private clinics and pharmacies.

Torres’ committee also wants information on how medications are being released to Medicaid patients from PHI, Brabu Pharmacy, and/or any other pharmacies.

“Although not listed in the letter, there are other issues related to Medicaid that we will discuss with both Medicaid and the Finance secretary,” Torres told Saipan Tribune.

Senate President Paul Manglona (Ind-Rota), Senate floor leader Pete Reyes (R-Saipan) and other senators took turns asking Larson and the governor’s special adviser for management and budget Vicky Villagomez on Medicaid funding during Monday afternoon’s session.

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