Medicaid Benefits: Online Database

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Acute Care Services

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Long-Term Care Services

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Benefits by State: Northern Mariana Islands (October 2008) Notes

Acute Care Services

Is the Benefit Covered?	Copayment Requirement	Prior Approval Requirement	Coverage Limitations	Reimbursement Methodology	Populations Covered

Institutional and Clinic Services
Clinic Services, by an organized facility or clinic not part of a hospital: Freestanding Ambulatory Surgery Center
No
Clinic Services, by an organized facility or clinic not part of a hospital: Public Health and Mental Health Clinics
Yes					CN & MN - See territory-specific FN
Federally Qualified Health Center Services
No
Inpatient Hospital Services, other than in an Institution for Mental Diseases
Yes					CN & MN - See territory-specific FN
Outpatient Hospital Services
Yes					CN & MN - See territory-specific FN
Rehabilitation Services: Mental Health and Substance Abuse
No
Rural Health Clinic Services
No
Practitioner Services
Certified Registered Nurse Anesthetist Services
No
Chiropractor Services
No
Dental Services
Yes		Specified services			CN & MN - See territory-specific FN
Medical and Remedial Care - Other Practitioners

Medical/Surgical Services of a Dentist
Yes			1 inpatient hospital visit/day		CN & MN - See territory-specific FN
Nurse Midwife Services
No
Nurse Practitioner Services
No
Optometrist Services
Yes					CN & MN - See territory-specific FN
Physician Services
Yes					CN & MN - See territory-specific FN
Podiatrist Services
No
Psychologist Services
No
Prescription Drugs
Prescription Drugs
Yes		Non-preferred drugs	30 day supply		CN & MN - See territory-specific FN
Physical Therapy and Other Services
Occupational Therapy Services
Yes		Yes			CN & MN - See territory-specific FN
Physical Therapy Services
Yes		Yes			CN & MN - See territory-specific FN
Services for Speech, Hearing and Language Disorders
Yes		Yes			CN & MN - See territory-specific FN
Products and Devices
Dentures
Yes			Limited to dentures delivered by government-operated facility		CN & MN - See territory-specific FN
Eyeglasses
Yes		Yes	1 pair eyeglasses/2 years		CN & MN - See territory-specific FN
Hearing Aids
Yes		New or replacement hearing aid			CN & MN - See territory-specific FN
Medical Equipment and Supplies
Yes		Yes	1 wheelchair/5 years, non-motorized only		CN & MN - See territory-specific FN
Prosthetic and Orthotic Devices
Yes					CN & MN - See territory-specific FN
Transportation Services
Ambulance Services
Yes					CN & MN - See territory-specific FN
Non-Emergency Medical Transportation Services
Yes					CN & MN - See territory-specific FN
Other Services
Diagnostic, Screening and Preventive Services
No
Early and Periodic Screening, Diagnosis and Treatment
See service-specific FN.
Extended Services for Pregnant Women

Family Planning Services
See service-specific FN.
Laboratory and X-Ray Services, outside Hospital or Clinic
Yes					CN & MN - See territory-specific FN
Targeted Case Management
No

Long-Term Care Services


Community Based Care
Home and Community Based Services Waiver
No
Home Health Services, includes nursing services, home health aides, and medical supplies/equipment
Yes	Yes	Post-hospital care only, includes therapies	CN & MN - See territory-specific FN
Hospice Care
No
Personal Care Services
No
Private Duty Nursing Services
No
Program of All-Inclusive Care for the Elderly
No
Institutional Care
Inpatient Hospital, Nursing Facility and Intermediate Care Facility Services In Institutions for Mental Diseases, age 65 and older
No
Inpatient Psychiatric Services, under age 21
No
Intermediate Care Facility Services for the Mentally Retarded
No
Nursing Facility Services, other than in an Institution for Mental Diseases
Yes		Post hospital extended care only	CN & MN - See territory-specific FN
Religious Non-Medical Health Care Institution and Practitioner Services
No

Notes: The Commonwealth has a single government-controlled and operated hospital and health system that provides the majority of its citizens’ healthcare services. Like the other territories, the Commonwealth has a federal Medicaid financial participation rate of 50 percent, payable up to a ceiling specified in law. The Deficit Reduction Act of 2005 provided additional funds to the Commonwealth, thus increasing its payment ceiling for fiscal years 2006 and 2007. The ceilings for 2008 and subsequent years will be calculated by applying an adjustor, the medical care component of the Consumer Price Index, to the 2007 payment ceiling. The hospital and health system is paid on a charge basis using Medicare cost ceilings. This methodology is also used for nursing facility services provided off island. For any other services not available through the hospital and health system, providers are paid negotiated rates or the applicable rates paid by the off island Medicaid program.