Cruz Raises Concerns About GMH Urgent Care Compliance


GMH Administrator Joseph Verga says Vice Speaker Cruz’s concerns are unwarranted and unfounded.

Guam – Guam Memorial Hospital Administrator Joe Verga says concerns that Vice Speaker BJ Cruz raised regarding the newly opened Urgent Care Facility are unfounded. In fact Verga says concerns such as a fee schedule and CMS certification have long been addressed.

Vice Speaker BJ Cruz sent GMH Administrator Joe Verga a letter this morning outlining concerns he had regarding the hospital’s newly opened Urgent Care Center. The first issue Cruz raised was over a fee schedule. Cruz believes that the center has yet to set fees for new services. 

“In fact we had a meeting with all the insurers prior to urgent care opening where we discussed the fees and the fee schedule and with the insurers we modified our fee structure to cover our costs to a mutually acceptable rate,” says Verga.

The second point was compliance with the Centers for Medicare and Medicaid Services. Cruz, in his letter, said that “GMH should ensure that the new center complies with the CMS conditions of participation and reimbursement, especially if it is billing for the use of the facility and placing significant reliance on self-pay patients.”

“It is our responsibility to make sure we’re in compliance with conditions of participation at all times which we do, which we are. So the urgent care center is in compliance with all CMS and Joint Commition requirements and expectations currently, since we are both an accredited and certified hospital,” explains Verga.

The third issue, says Cruz, has to do with a reporting requirement under Guam law. GMH is required to submit to the legislature its plans for the Urgent Care Center ahead of time. Cruz believes the hospital is not in compliance with this law. 

“The plans, the resolutions were submitted to his office last February 14 2014. I regret the vice speaker obviously didn’t get his copy and I will be happy to provide him one,” notes Verga.

Verga points out that the reports submitted to the Legislature were stamped received the same day it was submitted.

Finally, Cruz says he’s concerned that with the addition of an Urgent Care Center at GMH, there may be a redundancy in government services, such as Urgent Care services at the Department of Public Health. 

“Public Health is–their federal grants prohibit them from operating as urgent care, in fact they do not operate urgent care and in fact we do coordinate with them. They were part of our urgent care planning committee,” argues Verga. “So, no, there is no redundancy in Urgent Care Services.”

“I was kind of confused when I received this letter because I didn’t know where it was coming from. But all of the concerns that he raised here are really unwarranted, they’re unfounded,” Verga says.

You can read the letter Cruz sent to Verga by clicking on the file below.