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Guam - DOA Director Benita Manglona Wednesday defended her decision not to pursue penalties against SelectCare for late filings of reports last year.
Testifying at an oversight hearing called by Vice Speaker B.J. Cruz, Manglona said that the cost of pursuing penalties would have outweighed the benifits.
The focus of the oversight hearing was on the question of whether or not Selectcare should have to pay a penalty of up to $900-thousand dollars for filing as many as 3 different claims reports late.
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Reading from a prepared statement, the DOA Director contested the law that requires a penalty saying it was "ambiguous" about when the reports on medical claims payments should be filed. However she later conceded under questioning by the Vice Speaker that at least 2 of the reports had been filed late.
Still, Manglona pointed out that DOA can not just demand payment of $900-thousand dollars from a provider. "Selectcare is entitled to due process", she said. And there is time and costs associated with convening an administrative review which would have to decide on whether a penalty should be applied, "that's another un-funded mandate," she said.
In addition, Manglona pointed out that GovGuam currently owes SelectCare $1.4 million dollars in outstanding premiums, and that GovGuam has frequently made late premium payments to SelectCare in the past, but Selectcare has not demanded interest on the late payments, which the law entitles them too, if they had asked for it.
Another consideration said Manglona is that any penalty paid by SelectCare, would end up being deducted from the premium rebates SelectCare is about to pay back to GovGuam and its employees.
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