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CNMI cuts Medicaid services


By Pacific Island Times News Staff

Saipan-- Due to financial constraints that necessitated critical cost-cutting measures, the Commonwealth Medicaid Agency will cut its services to subscribers, according to the office of the CNMI governor.


“In an effort to sustain the program and ensure medically necessary services are not disrupted, temporary limitations, restrictions or suspensions will be implemented and taken into effect on June 1, 2023, and end no later than Sept. 30, 2023,” according to the governor’s office.


Children, aged 0 to 20, however, will be exempted from the service reduction policy for “the purposes of early and periodic screening, diagnostic and treatment services through prior authorization” supported by a physician’s certification of “medical necessity.”


Dialysis services will remain available at any of Medicaid’s approved provider networks in the CNMI.


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The following services will be suspended:

  • Dental Services

  • Outpatient Physical Therapy and Related Services

  • Home Health Physical Therapy, Home Health Aide, or Medical Social Worker services

  • Prosthetic Devices

  • Vision Services

The Medicaid office will limit the services for the following:

  • Home Health Services* - Skilled Nursing Services only

  • Durable Medical Equipment will be restricted to monthly rental only

  • Accessories required for the use of a DME and Medical supplies will be restricted to critical cases

  • Prescribed Drugs**

  • Transportation**

The following services will be restricted to the Commonwealth Healthcare Corp. Tinian Health Center, Rota Health Center, or a federally qualified health center:

  • Outpatient Hospital Services

  • Laboratory and X-Ray Services

  • Family Planning and Pregnancy-Related Services

  • Physician, licensed practitioner, and any other medical care services

  • Clinic Services

"Exceptions may be made if CHCC or the FQHC is unable to provide the services in a timely manner by a written authorization signed by the designated staff. The service provider exception authorization form must be completely filled and signed by the two entities," the governor's office said.



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