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Pay – And Still Be Turned Away

MAJURO, Marshall Islands (September 13, 2002 - Marshall Islands Journal)---Even Marshall Islands residents who pay for the extra -- "supplemental" -- health insurance program are being turned away from Hawai‘i hospitals.

Marshall Islands Social Security Administration (MISSA) vice chairman Jack Niedenthal, responding to the concerns of a supplemental program member, said that while the supplemental program is in fact covering its costs through membership fees, the Hawai‘i hospitals do not see medical referrals and the supplemental insurance programs as separate programs.

"The problem is that Hawaii Pacific Medical Referrals sees all of these programs – the RMI referral plan and the supplemental plan – as the same, as do the hospitals in Honolulu, so when the money dries up they shut down everything," Niedenthal said.

"The only thing we can do at MISSA at this point is urge the government to meet their commitments with a large payment as soon as possible, which we have done in the past and which we will do again." Niedenthal said that the most unfortunate part of the imminent suspension of medical referral services is that the supplemental plan now pays for itself.

The supplemental plan offers off-island medical services for people who pay a quarterly insurance premium to MISSA for the extra service. "We want to keep the supplemental plan going," said MISSA administrator Saane Aho. Aho said that the supplemental plan accounts for less than three percent of the total due to Hawai‘i hospitals, and is paying for itself.

Marshall Islanders are being turned away from hospitals in Honolulu because the government is again behind in paying medical referral bills.

Since a week ago Monday, both Kapiolani Children’s Hospital and Straub Hospital, which handle large number of RMI medical referral cases, are no longer providing service to referral cases unless cash deposits are made by patients prior to admission.

One Marshallese patient getting treatment in Honolulu reported that she was told late last week when she went to Straub for an appointment that she’d have to pay 100 percent of the cost of the visit to see the doctor.

The RMI currently owes about $2.4 million to several Hawai‘i medical facilities.

Hawaii Pacific Medical Referrals (HPMR), the company that handles RMI medical referrals in Hawai‘i, told Marshall Islands officials that it will suspend handling RMI referrals on September 15 (this weekend) unless the following is received:

MISSA, until recently, administered the medical referral program. The Nitijela amended the law earlier this year to move the health fund administration back to the Ministry of Health.

Cannon said that one of the serious problems resulting from lack of payments from the RMI is that Hawai‘i hospitals within the HPMR network will stop providing service to RMI patients. Kapiolani and Straub have both notified HPMR that they will no longer provide services for RMI patients because of lack of payments, Cannon said.

Cannon said that HPMR has made the decision to "suspend" rather than "terminate" the agreement with the RMI because it believes that "prompt decisive steps taken by the Marshall Islands government and/or MISSA can rescue this relationship."

He added, however, that if the payments and payment plan are not provided by October 15 HPMR will terminate the agreement.



The government has proposed a $500,000 appropriation for medical referrals in the fiscal year 2003 national budget. This amounts to less than 25 percent of what is currently owed to Hawai‘i hospitals. Earlier this week, MISSA paid $200,000 to HPMR, its Hawai‘i referral coordinator, and the Ministry of Finance has promised an additional $300,000 this week, which MISSA administrator Saane Aho said should hold off the suspension of medical referrals through the end of September. The RMI paid $200,000 in June, and approved another $800,000 medical referral payments in July, but this wasn’t paid for lack of funds leading to the current threat of suspension of the program.

The Marshall Islands Journal, Box 14, Majuro, Marshall Islands 96960 E-mail:  Subscriptions (weekly): 1 year US $87.00; international $213.00 (air mail).

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