Medicaid owes providers over $15M

The CNMI Medicaid Office owes private medical providers both on- and off-island more than $15 million in outstanding reimbursement obligations, according to program officials yesterday.

Medicaid administrator Helen Sablan and the governor’s special adviser for Medicaid program Esther Muña acknowledged the program’s huge debt to vendors but could not say when the government will pay these arrears.

Medicaid is a health subsidy program for indigent individuals and families. The federal and state governments share Medicaid costs.

In a visit to their offices yesterday, Muña and Sablan pointed out that the CNMI Medicaid has limited funds. Its annual budget is only $2.4 million and allotments from its local share amount to only $200,000 each month. Along with the federal share, the program can only disburse $444,000 monthly for all products and services provided to eligible patients.

The two cited the government’s budget woes and the matching requirement for the program as factors behind the delayed reimbursements.

It was learned that most Medicaid vendors have not been paid since fiscal year 2011 but the two said there’s nothing they can do about it as the government is experiencing severe cash flow problems.

According to Muña, there’s a lot of money for the Medicaid program from the federal side, estimated at over a $100 million, including the latest funding for the program’s expansion. However, the CNMI cannot tap these available funds until matching funds are identified, Muña said.

“It’s nice when these monies come in, but we cannot touch that unless we have local funds and that’s really our problem,” said Muna, referring to the $90 million that’s available until 2019 plus $25 million for the program’s expansion and others.

Among the biggest private providers on island is PHI Pharmacy, which suspended its services to Medicaid patients since Sunday due to more than $1 million owed it by Medicaid.

It was learned that PHI Pharmacy, for example, has been sending billing that is more than the program’s allotment of $400,000 a month. Sablan and Muña pointed out that with very limited funding for the program, “the small pie has to be split in several cuts” each time a disbursement is allowed.

Marianas Medical Center also announced the suspension of similar services for Medicaid patients starting yesterday until they collect their reimbursement. Sablan disclosed that her office owes MMC less than $200,000.

Medicaid also has providers off-island: Hawaii, Guam, and San Diego. These companies, they said, are also owed by the Medicaid program. They did not disclose the breakdown of current obligations to providers pending completion of updated numbers.

Sablan disclosed that the government has been trying to find other alternatives to the matching requirement, but efforts have been unsuccessful.

Moneth G. Deposa | Reporter

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