[Congressional Record Volume 165, Number 114 (Tuesday, July 9, 2019)]
[Extensions of Remarks]
[Pages E882-E883]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




      MEDICAID AND CHIP TERRITORY TRANSPARENCY AND INFORMATION ACT

                                 ______
                                 

                  HON. GREGORIO KILILI CAMACHO SABLAN

                    of the northern mariana islands

                    in the house of representatives

                         Tuesday, July 9, 2019

  Mr. SABLAN. Madam Speaker, today, I introduce the Medicaid and CHIP 
Territory Transparency and Information Act, which would require the 
Centers for Medicare & Medicaid Services (CMS) to publish on its 
website, and periodically update, specified information related to 
federal expenditures under Medicaid and the Children's Health Insurance 
Program (CHIP) in each of the U.S. territories.
  Presently, data reporting for the Northern Mariana Islands' (NMI) 
Medicaid program is waived at the discretion of Secretary of Health and 
Human Services, as allowed by Section I902(j) of the Social Security 
Act. American Samoa also has this waiver. Absent this waiver, other 
insular areas are required to maintain appropriate reporting systems as 
a condition of receiving Medicaid funds. However, there is little 
evidence to suggest that CMS has been carrying out any robust 
oversight. An April 2016 Government Accountability Office report found 
that ``the lack of enforcement of program integrity mechanisms and 
information systems--have contributed to the limited federal program 
integrity efforts in the territories.'' The report goes on to state 
``until recently,

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CMS regulations exempted territories from the requirement to develop a 
Medicaid Management Information System, which could provide more detail 
on the territories' Medicaid and CHIP spending, including increasing 
the level of detail on the territories' . . . reporting.''
  Data collection on existing insular area Medicaid programs is not 
only important for transparency and accountability, but essential if 
long-term Medicaid funding solutions are to be developed for our most 
remote U.S. jurisdictions. Gathering enrollment, utilization, and 
expenditure data will allow for a greater understanding of unique 
health care needs--enabling local government and CMS officials to make 
evidenced based decisions when it comes to Medicaid program 
improvements for our insular areas.
  The gentleman from Florida, Mr. Bilirakis originally introduced this 
bill in the 115th Congress and is an original co-sponsor of this bill 
today along with my colleagues, Ms. Plaskett, Mrs. Radewagen, Mr. San 
Nicolas, and Miss Gonzalez-Colon. This bill is important to the future 
of Medicaid in the U.S. Territories. I urge all my colleagues to 
support this bipartisan legislation.

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