Insurance Fraud NEWS
$360M NMI Medicaid bill heads to floor
July 22, 2019, Washington, DC
The $360 million promised to the NMI Medicaid office now heads to the floor of the U.S. House of Representatives for a vote after the legislation was reported out of the House Committee on Energy and Commerce.
U.S. Rep. Darren Soto’s (D-FL) H.R. 3631, also known as the Territories Health Care Improvement Act, zoomed past the House Committee on Energy and Commerce after it obtained enough support last July 11, 2019, just two days after the legislation was introduced in the U.S. House.
The bill now heads to the floor of the House for action, alongside the No Surprises Act, which protects patients who unknowingly receive expensive care from doctors not in the patient’s insurance network.
According to Delegate Gregorio Kilili C. Sablan (Ind-MP), H.R. 3631 would give the CNMI $60 million every year for six years to fund the Medicaid health insurance program.
“Currently, the Marianas gets a fixed block grant, $6.7 million in fiscal [year] 2019. This is a nine-fold increase, better than any other area receives in the [legislation],” Sablan noted in a statement.
Under the 2010 Affordable Care Act, also known as Obamacare, the NMI was provided $109 million. The funds were completely depleted in March 2019, according to the NMI Medicaid office, until Sablan was able to secure $36 million for the NMI through a floor amendment to the disaster recovery bill in January 2019.
“That money, along with another $8.2 million…from the Department of Health and Human Services in April 2019, has kept the program running,” a statement from Sablan’s office noted.
Under H.R. 3631, the NMI is not obligated to meet the local match for federal Medicaid money until 2022.
“Zero local match in 2019, 2020, and 2021 will take pressure off of Commonwealth government resources,” Sablan noted. “This is particularly good news given the current government austerity, as the economy recovers from last year’s typhoons and with the revenue drop from the tourism and gambling sectors.”
“The Commonwealth budgeted $4.64 million for Medicaid matching last year. That money can all be saved now and for the next two years. It can be used to repair schools or for other recovery efforts,” he added.
H.R. 3631 among other things, also directs the CNMI to annually report on how the Medicaid money is being used to increase access to health care, increase covered benefits, and expand provider networks in efforts to make program integrity improvements.
American Samoa, Guam, and the CNMI will also be required to begin reporting within four years to the Transformed Medicaid Statistical Information System of the U.S. Department of Health and Human Services just as Puerto Rico, the U.S. Virgin Islands, and all the other states already do.
Also, American Samoa, Guam, and the CNMI will be required to show progress on establishing a Medicaid fraud control unit in their respective Attorney General’s Office.
Sablan previously held a hearing on the “Medicaid cliff,” where NMI Medicaid administrator Helen Sablan noted in her testimony in the U.S. Congress that the NMI is already in “freefall” after using up all of its Medicaid money right after Super Typhoon Yutu. Commonwealth Health Care Corp. chief executive officer Esther Muña also testified for the CNMI, alongside medical representatives from Guam, American Samoa, Puerto Rico, and the U.S. Virgin Islands.
Sablan noted that this started the momentum for the legislation, allowing for a similar hearing by the Health Subcommittee in June to follow.