Provider Information and Updates

Required Provider Agreement:

The Medicaid maintains agreements with all providers in the CNMI and Guam furnishing services under the plan in order for the CNMI Medicaid to pay for services incurred by the Medicaid recipients.  No provider agreement no payment for services.  Also, the provider agrees to:

  • Keep any record necessary to disclose the extent of service the provider furnishes to patients;
  • On request, furnish to the Medicaid Agency or the Secretary, any information maintained under (a) of this section and any information regarding payments claimed by the provider for furnishing services under this plan;
  • Maintain the confidentiality of patient information for other than Medicaid or program administrative purposes;
  • Not discriminate against any individual seeking services under this plan, on the basis of race, sex, religion, color, national origin, or handicap; and
  • Not seek additional payments from patients beyond those allowed under the state plan.

For providers in Hawaii or in off-island jurisdictions other than Guam, the Medicaid Agency relies on the provider agreements in place for the Medicaid programs in the respective State(s).

List of Current Providers

Provider Requirements
Required Documentation to Submit a Provider Agreement Application

Provider Agreement Form
Application/Agreement to Participate as a Provider of Service in the Commonwealth of the Northern Mariana Islands Medicaid Program

Agreement Form Attachment
Attachment 1 to CNMI Medicaid Provider Agreement

Standard Terms and Conditions 

Attachment 2 to CNMI Medicaid Provider Agreement 

MP SPA 12-001 Attachment Pages
Limitations on Services

MP SPA 12-004B Approved Package
Reimbursement Methodology for Covered Services

CNMI SPA 14-001 Approved Package
Payment of Services