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By Jayvee Vallejera

SAIPAN, Northern Mariana Islands (March 29, 2002 – Saipan Tribune)---Based on a recent communication from the Queen’s Medical Center in Honolulu, Hawai‘i, the government’s unpaid medical claims at the hospital now stand at $1.8 million.

Rep. Benjamin B. Seman, who is chairman of the House Committee on Health and Welfare, said the hospital recently wrote him a letter highlighting this concern, with an offer to give the CNMI a 25 percent discount if it helps to settle the debt.

Seman quickly added, though, that this $1.8 million is a figure coming from the hospital and may not necessarily be accurate or reliable.

"I still need to sit down with Medical Referral here in the CNMI and the hospital to cross-check those claims to see if they haven’t really been paid yet or have been paid already and have not been credited. We need to do a cross-check and verify if they are legitimate claims," he said.

Seman expressed belief, though, that 75 to 80 percent of this $1.8 million debt in medical claims is the responsibility of patients, which means they have to pay.

Queen’s Medical Center has already closed its doors to patients from Micronesia, including the Commonwealth, due to debts.

Seman has just arrived from a fact-finding mission in Honolulu, where he went to check the status of these claims that have not been paid to the health providers in Honolulu.

When asked if the CNMI will have to shoulder this debt, he said: "Right now, the provider wants the CNMI government to pay for this because they feel it is the CNMI’s responsibility to take care of this debt since it was the CNMI that sent the patients over."

The problem, he said, usually occurs when the amount in the final bill exceeds the actual benefits that the patient should receive, which makes the patient personally responsible for paying the bill.

"Some of the patients from the CNMI have maximized their benefits for the calendar year, which means they have also maximized their benefits with Medical Referral. When we have a $250,000-bill, $50,000 of that will be paid by your insurance, while $50,000 will be paid by Medical Referral if you qualify. So, the remaining $150,000 is the patient’s share and, right now, the problem is that patients are not paying their responsibility."

However, a lot of these patients are indigent and have no income, said Seman. "Even if you take these patients to court and put them in jail, they still can’t pay. So that’s something that we need to address because we’re sending a lot of patients that don’t have any form of income and my philosophy is, if the government sends someone to Honolulu, they should take care of that."

At the moment, the only health provider on Hawai‘i that is open to CNMI patients is Straub Medical Clinic, which remains open since it is the health provider of the Hawaii Pacific Medical Referrals, the third-party administrator of Group Health and Life Insurance.

"But then, we have several patients that we refer to Straub that don’t have government health insurance. We send them to Straub because Straub is the only one that is still accepting our patients. But I see that, sooner or later, they will also close their doors to us and it’s going to be a problem," Seman said.

The CNMI also owes Straub unpaid medical claims but Seman said he does not have the figures at the moment. "I have asked Straub to send me that and then I’ll meet with Medical Referral to review their records for accuracy," he added.

For additional reports from The Saipan Tribune, go to PACIFIC ISLANDS REPORT News/Information Links: Newspapers/The Saipan Tribune.

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