Senate to conduct oversight hearing of MRC
By: L.N. Reklai
August 18, 2016 (Koror) “A government should treat its citizens equally. There should be no “ngelekek chelsel and ngelekek budel,” stated presidential candidate Senator Sandra Pierantozzi, responding to a question on improving healthcare services in Palau at the Presidential debate yesterday.
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Allegations made are that some people are bypassing the regular process of Medical Referral Committee and getting off-island medical care and that their treatments are paid for by the National Health Insurance after the fact.
Waving a copy of letter written by Senator Joel Toribiong to Dr. Robert Emais, Chairman of Medical Referral Committee, questioning why some patients seem to be getting preferred treatment than others, Senator Pierantozzi stated that the government was providing unequal treatment to its citizens. “I’ve asked the Chairman of the MRC about this and he instructed me to dig deeper and so I am going to conduct a hearing on this matter,” added Pierantozzi.
In addition to this letter, a posting on social media by Senator Toribiong shows a billing and a request for payment from the government for President’s mother-in-law’s treatment at Guam Memorial Hospital. The posting showed details of her treatment at the Guam Memorial Hospital.
In response, President Remengesau clarified that there is a Medical Referral Committee tasked with the responsibility of approving medical referral patients and questions should be posed to them.
Ms. Ulai Teltull, Administrator of the National Health Care Fund, in an interview yesterday stated that there is an existing policy by the National Health Care Fund allowing exceptions for emergency cases.
National Health Care Fund Governing Committee adopted a policy on March 12, 2015, allowing exceptions for off-island referral without going through the normal process, but limited to specific emergency cases only: Injuries caused by accident and Strokes and/or failure of organs.
Citing one of the cases where personnel under the Ministry of State working as liaison officer in Guam, suffered a stroke and had to be treated immediately at the Guam Memorial Hospital, as one such example.
One such case involved a person who was in an auto accident and was flown out of Palau immediately but was approved later by the Medical Referral Committee due to the emergency nature of his case.
“There have been patients that were sent off-island without going through normal process due to the nature of their injuries and patients that have had treatments while overseas, again due to the emergency nature of their cases and were approved for payment afterwards,” stated HCF Administrator Ulai Teltull.
“The Medical Referral Committee will review such cases after the fact and if the case meets the criteria, it will go through the process and request for reimbursement,” added Teltull.
Policy states, “It is determined that while exceptions for coverage of emergency case is hereby established, the approval process of MRC, reviewing and approving the type of treatment including reimbursement process shall be consistent and comply with existing guidelines for requesting reimbursement of PHI.” [/restrict]