THE NORTHERN MARIANA ISLANDS SAIPAN VOLUME 20 …

COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS SAIPAN NlARlANA ISLANDS

VOLUME 20 NUMBER 02

FEBRUARY 15,1998

Emergency Adoption and Intent to Adopt Amendments to the Revenue and Tax Regulations Number 2200. Secretary of Finance Division of Revenue & Taxation.. ........................... ..I5822

Emergency Adoption and Intent to Adopt Amendments to the Rules and Regulations Governing the Health Screening Requirements of Alien Employees. Department of Public Health ............................................................... 15842

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\ Emergency Adoption and Intent to Adopt Amendments to the Rules and Regulations Governing the Medical Referral Program. Department of Public Health.. ............................................................ .I5851

Proposed Amendments to the Schedule of Fees. Department of Public Health. ........................................................... ..I5861

Office of the Secretary Department of Finance

P.O. BOX 5234 CHRB SAIPAN, MP 96950 TEL. (670) 664-1 100 FAX: (670) 664-111 5

NOTICE OF EMERGENCY ADOPTION - OF AMENDMENTS TO THE REVENUE AND TAX REGULATIONS NUMBER 2200 AND NOTICE OF INTENTION

TO ADOPT THESE AMENDMENTS ON A PERMANENT BASIS

Emergencv: The Acting Secretary of Finance for the Commonwealth of the Northern Mariana Islands finds that pursuant to Title 1 CMC Division 9, Chapter 1, and in particular 1 CMC $91 04(b), that the public interest requires the adoption, on an emergency basis of Amendments to the Revenue and Taxation Regulations Number 2200 as published in the Commonwealth Register Vo1.17, No. 6, July 15, 1995 commencing at page 13539, with amendments published thereto in the Commonwealth Register Vol. 18, No. 2, February 15, 1996 commencing at page 14002. The Adoption of the Amendments to the Revenue and Tax Regulations on an emergency basis will assure consistency and provide guidance in applying recent changes made to the tax laws. The Secretary of Finance further finds that the public interest requires these amendments to become effective immediately upon concurrence of the Governor and filing with the Registrar of Corporations; and shall remain effective for a period of 120 days, unless adopted within that time as permanent regulations.

Reason for Emer~encv: The public interest requires adoption of the Amendments to the Revenue and Tax Regulations upon fewer than thu-ty (30) days notice due to the fact that such

\ amendments are necessary in light of the upcoming tax filing season and the recent adoption to changes in the tax law. Specifically, the emergency adoption is needed to assist the public in complying with recent changes to the tax laws as well as to assure consistency in applying these recent changes. Publication in the Commonwealth Register of the proposed amendments to Revenue and Taxation regulations attached hereto could occur no earlier than February 15, 1998; and waiting for public comment would result in it being April 26, 1998 before such amendments could finally be adopted and become effective. This would provide for filing tax returns inconsistently and may result in non-compliance with the tax laws.

Contents: These Amendments to the Tax Regulations explain how to procedurally comply with the Educational Tax Credit during its initial transition period, as well as in the future. Additionally, the Amendments explain how to calculate and allocate the individual rebate for tax year 1997, due to the changes made by P.L. 10-74. Finally the regulations delete reference to interest, dividends, rents and royalties as being subject to tax due to repeal of the Earnings Tax Repeal as it relates to passive income. The Amendments to the Tax Regulations are published immediately following this Notice.

Public Comments: It is the intention of the Acting Secretary of Finance to adopt these Emergency Amendments to the Revenue and Tax Regulations No. 2200 as a permanent addition to the Tax Regulations pursuant to 1 CMC §§9104(a)(l) and (2). Therefore, publication in the Commonwealth Register of these proposed permanent Amendments to the Tax Regulations, this

t - Notice, and an opportunity for public comment pursuant to the requirements of the CNMJ

COMMONWEALTH REGISTER VOLUME 20 NUMBER 02 FEBRUARY 15, 1998 PAGE 15822

Administrative Procedure Act, are hereby provided. Comments on the Amendments to the Revenue and Taxation Regulations No. 2200 may be sent to: Esther Calvo, Acting Secretary of Finance, P.O. Box 5234 CHRB, Saipan, MP 96950 or delivered in person to the Office of the Secretary of Finance, Joten Commercial Center, 2nd Floor in Dan Dan.

Authoritv: The Acting Secretary of Finance is authorized to publish the Amendments to Revenue and Taxation Regulations No. 2200 pursuant to one or more of the following: 1 CMC §2553(a); 1 CMC $2557; 4 CMC 51104; 4 CMC §1701(c), and 4 CMC $1818; the CNMI Administrative Procedure Act, 1 CMC $91 0 1 et. seq.; and other applicable Commonwealth Law.

Issued by: Esther Calvo Acting Secretary of Finance

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Concurred by: rn Date

Pedro P. Snorio Date Governor

i

Donna C Date

Pursuant to 1 CMC $2153 as amended by P.L. 10-50, the rules and regulations attached hereto have been reviewed and approved as to form and legal sufficiency by the CNMI Attorney General's Office.

Dated t h i s 3 ' day of 3e$: ,1998.

By:

Elliott A. Sattler

Recorded by:

- Soledad B. Sasamoto Date Registrar of Corporations

COMMONWEALTH REGISTER VOLUME 20 NUMBER 02 FEBRUARY 1 5 , 1998 PAGE 15823

Office of the Secretary Department of Finance

P O BOX 5234 CHRB SAIPAN, MP 96950 TEL. (670) 664-1 100 FAX' (670) 664-1 11 5

ENDMENTS TO REVENUE AND TAXATION REGULATIONS NO. 2200

Purpose and Scope. - These regulation amendments are promulgated to implement the nonrefundable educational tax credit provided by Pub. L. 10-73, the rebate increase for individual taxpayers provided by Pub. L. 10-74, and the Earnings Tax amendments provided by Pub. L. 10-80. These amendments to the regulations are promulgated in order to be consistent with the aforementioned public laws passed by the 10th CNMI Legislature and are intended to provide information and guidelines to assist taxpayers in complying with Pub. L. 10-73, Pub. L. 10-74, and Pub. L. 10-80.

I. REGS TO IMPLEMENT PUB. L. 10-73

1. Amend Part I, Section 2200, General Provisions to add new section "2200.9" Captioned "PL 10-73 Educational Tax Credit" to read as follows:

2200.9. In General. 4 CMC sections 1205(a) and 1306(a) provide that a person may take, as provided in Pub. L. 10-73, cash contributions that are made during a tax year to quallfying educational institutions as a nonrefundable credit against the tax imposed by sections 1201,1202, and 1301 through 1304.

(a) Definitions.

(1) Cash Contributions: For a contribution to quallfy as a "cash contribution" as used in 4 CMC section 1205(a) and 4 CMC section 1306(a), the contribution must:

(i) not have been paid for tuition or fees charged by the educational institution;

(ii) not have been paid for books, computers, supplies, or other items used in attending the educational institution;

(iii) have been a "gift," within the general legal concepts defining a gift for tax purposes;

1 COMMONWEALTH REGISTER VOLUME 20 NUMBER 02 FEBRUARY 15, 1998 PAGE 15824

(iv) have been paid in cash, by check, or by credit card;

(v) not have been given to the educational institution in exchange for anything of value. For example, a cash contribution would exclude money given for a raffle ticket; and

(vi) not be given to the institution with instructions to be applied to a particular expenditure. The institution must have full discretion as to what expenditure to apply the contribution to.

(2) Educational Institution. The term "educational institution" as used in 4 CMC section 1205(c)(3) and incorporated in 4 CMC section 1306(c) shall have the same meaning as "educational organization" under section 170 of the U.S. Internal Revenue Code as applied in the CNMI under section 170 of the Northern Marianas Territorial Income Tax (NMTIT). Subject to all other requirements of the NM?TT's definition of "educational organization," an "educational institution" under the CNMI educational tax credit is generally one whose primary function is the presentation of formal instruction and which normally maintains a regular faculty and curriculum and normally has a regularly enrolled body of pupils or students in attendance at the place where its educational activities are regularly carried on. A n "educational institution" includes only the CNMI Public School System, the Northern Marianas College, and those organizations granted exempt status by the CNMI Division of Revenue and Taxation as an "educational organization" or "educational institution" under the NMTIT, the BGRT, or the ET, under the procedures specified in Part V - Section 2204 Tax Exempt Organizations - of Rev. and Tax Regulations No. 2200.

(3) Letter of Determination. The term "Letter of Determination" as used in 4 CMC section 1205(c)(3) and incorporated in section 1306(c) means the determination letter issued by the CNMI Division of Revenue and Tax granting an organization exempt status as an "educational institution" or "educational organization" under section 501(c)(3) of the U.S. Internal Revenue Code as applied in the CNMI under section 501(c)(3) of the NMTIT and as applied for determining an "educational organization's" or "institution's" exempt status under the BGRT and ET.


(b) Documentation Required. -

(1) Scope. Under 4 CMC sections 1205(d) and 1306(d), a taxpayer must furnish the following to obtain the educational tax credit: (1) a properly documented receipt issued by the recipient institution which must include, at a minimum, the name and tax identification number of the institution, the taxpayer's name and tax identification number, the date of payment and the amount paid, and the purpose of the donation; and (2) a copy of the Letter of Determination with respect to the exempt status of the recipient institution.

(2) Specific Documentation Required. For each cash contribution regardless of amount, taxpayers are not required to submit the information specified in 4 CMC sections 1205(d) and 1306(d) and Reg. Sec. 2200.9(b)(l). Instead, taxpayers are required to:

(i) maintain, for a period of no less than six (6) years,

(A) a written receipt from the educational institution that must include the following information:

(1) the educational institution's name and tax identification number;

(2) the taxpayer's name and tax identification number;

(3) the date the contribution was paid to the institution;

(4) the amount of cash contributed;

(5) the purpose of the contribution; and

(6) whether the institution gave the taxpayer any goods or services as a result of the contribution; and if so, a description and good faith estimate of the value of any goods or services provided.


(B) A copy of the Letter of Determination with respect to the tax exempt status of the recipient institution, if the recipient organization is other than the Public School System or the Northern Marianas College; and

(ii) submit information in a form or scheduled as prescribed by the Secretary.

(3) Failure to Comply. No educational tax credit will be allowed under 4 CMC sections 1205(d) or 1306(d) unless the taxpayer complies with all the applicable provisions of Rev. and Tax Regs. Section 2200.9(b).

(c) Educational Tax Credit -- Allowable Amount Applied Only Against BGRT (With Allocation Rules).

(1) $5,000 or More Quarterly BGRT Liability. If a person's BGRT liability for any quarter is $5,000 or more, the person can claim an educational tax credit for contributions made in that quarter up to the lesser of (a) $5,000 or (b) $5,000 less any allowable credit claimed in prior quarters in the same taxable year. The calculated allowable credit can be applied entirely to the quarter during which the contribution was made or can be allocated over remaining quarters, if any, in the remaining taxable year; the credit cannot be allocated to previous quarters in the same taxable year (instead, the credit will be adjusted on the person's final BGRT return for that year).

(i) Example No. 1: If a person's BGRT liability for the first quarter is $8,000 and the person makes a $5,000 charitable contribution to a quallfying educational institution during the first quarter, the person can claim a $5,000 educational tax credit during the first quarter to offset the $8,000 BGRT liability.

(ii) Example No. 2. If a person makes a $5,000 charitable contribution to a quallfying educational institution during the first quarter, has a $2,000 BGRT liability for the first quarter, has a $3,000 BGRT liability for the second quarter, and has claimed a $2,000 educational tax credit for the first quarter, the person can claim a $3,000 credit during the second quarter to offset the second quarter liability.

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(iii) Example - No. 3. Assume the same facts as Example No. 2, except that the person has only a $500 tax liability in the second quarter. Under this scenario, the person can claim only a $500 credit during the second quarter to offset the second quarter liability, provided that the maximum remaining credit shall be the lesser of $2,500 or the BGRT for the final two quarters.

(iv) Example No. 4. If a person has a $5,000 BGRT liability for the first, second and third quarters of a taxable year, has a zero liability for the fourth quarter, and makes a $5,000 cash contribution to a quallfying educational institution during the fourth quarter, the person would not allocate the educational tax credit to prior quarters; instead the person's fourth quarter BGRT return will be adjusted on the forms prescribed by the Secretary.

(2) Ouarterlv BGRT Less Than $5,000. If a person's BGRT liability for any quarter is less than $5,000, the person can claim an educational tax credit for contributions made in that quarter up to the lesser of (a) the amount of that quarter's BGRT liability or (b) $5,000 less any of the allowable credit claimed in prior quarters in the same taxable year. The calculated allowable credit can be applied entirely to the quarter during which the contribution was made or can be allocated over remaining quarters, if any, in the remaining taxable year; the credit cannot be allocated to previous quarters in the same taxable year (instead, the credit will be adjusted on the person's final BGRT return for that year).

(i) Example No. 1. If a person's BGRT liability for the second quarter is $4,000, the person makes a $5,000 cash contribution to a quallfying educational institution during the second quarter, and the person has claimed no educational tax credit for the first quarter, the person can claim a $4,000 educational tax credit for the second quarter to offset the $4,000 liability. The remaining $1,000 cash contribution can be carried forward to the third or fourth quarter, provided that the BGRT liability for those quarters equals or exceeds $1,000.

(ii) Example - No. 2. Assume the same facts as Example No. 1, except that the person claimed an


educational tax credit in the first quarter in the amount of $3,500. Under this scenario, the person can claim a $1,500 ($5,000 less $3,500) educational tax credit for the second quarter to offset the $4,000 liability (the lesser of $4,000 or $1,500).

(iii) Example No. 3. A person makes a $5,000 cash contribution to a qualifying educational institution in the first quarter, has a $1,500 BGRT liability in the first, second, and third quarter, has a $2,000 liability in the fourth quarter, and wants to use the maximum amount of allowable credit in each quarter, the person can claim the following educational tax credits:

1st quarter: $1,500 -- is lesser of ($1,500) or ($5,000 less $-0-)

2nd quarter: $1,500 - is lesser of ($1,500) or ($5,000 less $1,500 = $3,500)

3rd quarter: $1,500 -- is lesser of ($1,500) or ($5,000 less $3,000 = $2,000)

4th quarter: $500 - is lesser of ($2,000) or ($5,000 less $4,500 = $500)

(iv) Example No. 4. Assume the same facts as Example No. 3, except that the person wants to utilize his educational tax credit only in the fourth quarter and, thus, claims no credit in the first, second, or third quarters. Under this scenario, the person is only entitled to a $2,000 educational tax credit to be applied against the $2,000 fourth quarter liability; no credit can be applied for prior quarters; (instead, the credit will be adjusted on the person's final BGRT return for that year).

(d) Educational Tax Credit Allowable Amount -- Applied Against BGRT, WST, and ET. Under 4 CMC sections 1205(a) and 1306(a), a person is entitled to utilize the educational tax credit against the person's Wage and Salary Tax, Earnings Tax, or Business Gross Revenue Tax liability. The maximum annual credit available is the lesser of (a) the sum of the person's WST, ET, and BGRT or (b) $5,000.

(1) Timing of Credit for WST. A person can claim the educational tax credit against the WST in the allowable amount no earlier than upon the filing of the person's WST return for the corresponding year.

COMMONWEALTH REGISTER VOLUME 20 NUMB$R 02 FEBRUARY 15, 1998 PAGE 15829

(2) Timing of Credit for ET. A person can claim the educational tax credit against the ET in the allowable amount no earlier than upon the filing of the person's ET return for the corresponding year.

(3) Timing of Credit for BGRT. A person can claim the educational tax credit against the BGRT in the allowable amount under the rules specified in Rev. and Tax Regs. Sec. 2200.9(c).

(4) Examples.

(i) Example No. 1. A person has an annual WST liability of $6,500, an annual ET liability of $400, and an annual BGRT liability of $8,000. The person has made a $5,000 cash contribution to a quallfying educational institution during the same taxable year and has not yet claimed an educational tax credit with respect to the contribution. Because the person's accumulated WST, ET, and BGRT ($14,900) is greater than the person's cash contribution ($5,000), the person can choose to allocate the $5,000 educational tax credit among the WST, ET, and BGRT liabilities at the person's discretion, in amounts not exceeding the liabilities under those taxes up to a maximum accumulated credit for all three taxes of $5,000.

(ii) Example - No. 2. A person has an annual WST, ET, and BGRT liability of $1,500 each, has made a $5,000 cash contribution to a quallfying educational institution, and has not claimed an educational tax credit with respect to the contribution. The person can claim a $1,500 educational tax credit against the WST, ET, and BGRT liability; the remaining $500 cash contribution cannot be claimed as an educational tax credit in that year or any succeeding or prior years. However, the person may be entitled to use the remaining $500 as a charitable contribution deduction under the NMTIT, provided the contribution qualifies under section 170 of the NMTIT.

(e) Miscellaneous Rules.

(1) Educational Institutions With Pending Tax Exempt -

Applications. - - As specified in 4 CMC section 1205(c)(3) and incorporated in 4 CMC section 1306(c), an educational tax credit is allowed only for contributions made to educational institutions that have been granted tax


exempt status by the CNMI Division of Revenue and Taxation before the date of the contribution for which the credit is to be taken. Thus, contributions made to organizations that have not applied for or have applications pending on the date that a contribution is made will not be allowed to be used as an educational tax credit.

(2) Educational Institutions Granted Exempt Status by the U.S. Internal Revenue Service But Not by the CNMI Division of Revenue and Taxation. As specified in 4 CMC section 1205(c)(3) and incorporated in 4 CMC section 1306(c), an educational tax credit is allowed only for contributions made to educational institutions that have been granted tax exempt status by the CNMI Division of Revenue and Taxation. Thus, contributions made to educational organizations that have been granted tax exempt status by the U.S. Internal Revenue Service will only be allowed to be used as an educational tax credit if the recipient organization has received exempt status by the CNMI Division of Revenue and Taxation under Section 2204.6 of Rev. and Tax Regulations No. 2200 -- Application Process -- Previously Granted Tax-Exempt Status by U.S. Internal Revenue Service.

(3) Interaction with NMTIT.

(i) WST and ET Non-Refundable Credit. Under 4 CMC section 1205(a), a person may take the WST and ET as a nonrefundable credit against the tax imposed on CNMI sourced income under Subtitle A of the NMTIT under Chapter 7 of 4 CMC. The amount of the nonrefundable credit allowed shall be reduced by any educational tax credit claimed by the person as a credit against the person's accumulated WST and ET liability. For example, if the person has an accumulated $8,000 WST and ET liability and offsets that liability with a $5,000 educational tax credit, the maximum amount of nonrefundable credit that can be applied against the person's NMTIT liability is $3,000.

(ii) BGRT Non-Refundable Credit. Under 4 CMC section 1308 as amended by Pub. L. 9-59 and Pub. L. 10-73, a person may take the BGRT as a nonrefundable credit against the tax imposed on CNMI sourced income under Subtitle A of the NMTIT under Chapter 7 of 4 CMC. The amount of the nonrefundable credit allowed shall be reduced by any educational tax credit claimed by the person as a credit against the person's BGRT liability. For example, if the

8 COMMONWEALTH R E G I S T E R VOLUME 20 NUMBER 02 FEBRUARY 15, 1998 PAGE 15831

person has a $14,000 BGRT liability and offsets that liability with a $3,500 educational tax credit, the maximum amount of the nonrefundable credit that can be applied against the person's NMTIT liability is $10,500.

(iii) NMTIT Charitable Contribution Deduction. Under 4 CMC sections 1205(a) and 1306(a), no educational tax credit shall be allowed for any amount deducted in determining taxable income under the NMTIT as shown on the taxpayer's return. Thus, if a taxpayer has taken the educational tax credit under 4 CMC sections 1205 or 1306 and the person has claimed a charitable contribution deduction with respect to the same cash contribution under section 170 of the NMTIT, the educational credit shall be disallowed.

(4) Joint Returns. Spouses filing joint or separate returns shall each be entitled only to an annual maximum educational tax credit in the amount of the lesser of the individual spouse's cumulative tax liability under 4 CMC sections 1201, 1202, and 1301 through 1304 , or five thousand dollars ($5,000). One spouse shall not be entitled, whether filing joint or separate returns, to use his or her educational tax credit as a credit against his or her spouse's tax liability.

(i) Example. Wife makes a $5,000 cash contribution to an educational institution that qualifies for the education tax credit and the wife has a $3,000 cumulative tax liability under sections 1201, 1202, and 1301 through 1304. Husband makes no cash contributions during the same taxable year and has a $14,000 cumulative tax liability under sections 1201, 1202, and 1301 through 1304. Wife would be entitled to a $3,000 educational tax credit; she could not apply and her husband could not claim the remaining $2,000 cash contribution as an educational tax credit against his $14,000 tax liability.

(f) Transitional Rules.

(1) Scope. Pub. L. 10-73 became effective on November 12,1997. Transitional rules are provided to implement the educational tax credit from November 12, 1997, through December 31, 1997. The credit shall be allowed to be applied against the WST, ET, and the BGRT for that period under the following conditions:

COMMONWEALTH REGISTER VOLUME 20 N U M ~ R 02 FEBRUARY 15, 1998 PAGE 15832

(i) the person has satisfied all conditions specified in Pub. L. 10-73 and in these regulations that are applicable to the educational tax credit; and

(ii) the contribution must be made within the "tax year." "Tax year" means January 1,1997 through December 31,1997.

(2) Examples.

(i) Example No. 1: If a person makes a cash contribution to the Public School System on November 15, 1997, and wants to use that contribution as an educational tax credit against his or her fourth quarter 1997 BGRT tax liability that is due on or before January 31,1998, the person can.

(ii) Example No. 2: If a person makes a cash contribution to the Northern Marianas College on December 31, 1997, and wants to use that contribution as an educational tax credit against his 1997 WST or ET liability that is due on or before April 15,1998, the person can.

(iii) Example - No. 3: If a person makes a cash contribution to the Public School System on January 8,1998, and wants to use that contribution as an educational tax credit against his fourth quarter 1997 BGRT tax liability that is due on or before January 31, 1998, the person cannot. Similarly, the credit would also not be available against the person's 1997 WST or ET liability that must be paid on or before April 15,1998.

2. Section 2201.4 Sec. 2201.4(a) is amended to read as follows:

(a) In General. Except as provided by subsection (d) and pursuant to and as provided by 4 CMC section 1206 as amended by Pub. L. 9-59 and Pub. L. 10-73, a person may take the tax imposed on wages and salaries as a nonrefundable credit against the tax imposed on Commonwealth source income under Subtitle A of the NMTIT pursuant to Chapter 7 of Title 4. However, no

COMMONWEALTH REGISTER VOLUME 20 NUMElER 02 FEBRUARY 15, 1998 PAGE 15833

such credit shall be allowed for any amount deducted in determining taxable income under the NMTIT as shown on the taxpayer's return. .

3. Section 2201.4 Sec. 2201.4(b) is amended by deleting the first sentence and replacing it with the following:

(b) Withholding - by - Employers. - - In order for 4 CMC section 1206 as amended by Pub. L. 9-59 and Pub. L. 10-73 to apply at the time withholdings are deducted and remitted by an employer, the items of income subject to the NMTIT and the Wage and Salary Tax must be taxable and/or that withholding must be required at the time the NMTIT and Wage and Salary Tax was withheld or paid.

4. Section 2201.4 Sec. 2201.4(c) is amended by deleting the first sentence and replacing it with the following:

(c) Payment by Employees. - In order for 4 CMC section 1206 as amended by Pub. L. 9-59 and Pub. L. 10-73 to apply at the time employees who are required to pay the Wage and Salary Tax under 4 CMC section 1804(e), the items of income subject to the NMTIT and the Wage and Salary Tax must be taxable and/or that Chapter 2 payment must be required at the time the NMTIT estimated tax payment was made.

5. Section 2201.4 Section 2201.4 is amended to add new subsection (d) to read as follows:

(d) Reduction of Non-Refundable Credit for P.L. 10-73 Educational Tax Credit. The amount of the nonrefundable credit allowed under (a) and as provided by law shall be reduced by the amount of educational tax credit, allowed under 4 CMC section 1205, that is claimed by a person during the taxable year. See Regs. Section 2200.9(e)(3).

6. Section 2202.4 Section 2202.4(a) is amended to read as follows:

(a) In General. Except as provided by subsection (b) and pursuant to and as provided by 4 CMC section 1206 as amended by Pub. L. 9-59 and Pub. L. 10-73, a person may take the tax imposed on earnings as a nonrefundable credit against the tax imposed on Commonwealth source income under Subtitle A of the NMTIT pursuant to Chapter 7 of Title 4. However, no such credit shall be

( -


allowed for any amount deducted in determining taxable income under the NMTIT as shown on the taxpayer's return.

7. Section 2202.4 Section 2202.4 is amended to add a new subsection (b) to read as follows:

(b) Reduction of Non-Refundable Credit for P.L. 10-73 Educational Tax Credit. The amount of the nonrefundable credit allowed under (a) and as provided by law shall be reduced by the amount of educational tax credit, allowed under 4 CMC section 1205, that is claimed by a person during the taxable year. See Regs. Section 2200.9(e)(3).

8. Section 2203.9. Sec. 2203.9(a) is amended to read as follows:

(a) In General. Except as provided in subsection (c) and pursuant to and as provided by 4 CMC section 1308 as amended by Pub. L. 9-59 and Pub. L. 10-73, there will be allowed against the tax imposed on gross revenues (or any other Commonwealth tax or fee imposed under other Divisions or Titles of the Commonwealth Code in lieu of such tax) a nonrefundable credit against the tax imposed on Commonwealth source income under Subtitle A of the NMTIT pursuant to Chapter 7 of Title 4 of the Commonwealth Code. However, no such credit shall be allowed for any amount deducted in determining taxable income under the NMTIT as shown on the taxpayer's return.

9. Section 2203.9 Sec. 2203.9 is amended to add new subsection (c) to read as follows:

(c) Reduction of Non-Refundable Credit for P.L. 10-73 Educational Tax Credit. The amount of the nonrefundable credit allowed under (a) and as provided by law shall be reduced by the amount of educational tax credit, allowed under 4 CMC section 1306, that is claimed by a person during the taxable year. See Regs. Section 2200.9(e)(3).

10. Section 2206.11. Section 2206.11(a) is amended to read as follows:

(a) In General. Except as provided by subsections (b) and (f) and pursuant to and as provided by 4 CMC section 1206, section 1307, and section 1424, the taxes imposed on wages and

COMMONWEALTH REGISTER VOLUME 20 NUMmR 02 FEBRUARY 15, 1998 PAGE 15835

salaries, earnings, gross revenues, and the User Fee, will be allowed as a non-refundable credit against the NMTIT paid on the same items of income subject to these aforementioned taxes.

11. Section2206.11. Section 2206.11 is amended to add a new section 2206.11(f) to read as follows:

(f) Interaction With Pub. L. 10-73 Educational Tax Credit. The amount of the nonrefundable credit allowed under this section and as provided by law shall be reduced by the amount of educational tax credit, allowed under 4 CMC sections 1205 and 1306, that is claimed by a person during the taxable year. See Regs. Section 2200.9(e)(3).

11. REGS TO IMPLEMENT PUB. L. 10-74

1. Section 2206.11 Section 2206.11(a) is amended to delete the last sentence of 2206.11(a) and replace it with the following:

The "rebate base" is the NMTIT imposed on income derived from "sources within the Commonwealth" as determined by subsection (e) of these Regulations and paid by the taxpayer less the amount of the non-refundable credit allowable under sections 1206 or 1308 as amended by Pub. L. 9-59 and Pub. L. 10-73. [See Examples in subsection (g).]

2. Sec. 2206.11 Section 2206.11(b) is deleted in its entirety and replaced with the following:

(b) Deduction v. Credit. In lieu of taking the 4 CMC sections 1206,1308, and 1424 taxes as credits, a person may elect to treat such taxes as deductions allowed under the NMTIT to the extent allowed under the NMTIT.

3. Sec. 2206.12(& Section 2206.12(g) is amended by deleting Example No. 2 in its entirety and replacing with the following:

Example No. 2 For taxable year 1998, individual Taxpayer M has income in the following amounts and from the following sources: [I] $50,000 derived from wages and salaries received for services performed within the Commonwealth; [2] gain (as calculated under the NMTIT) from the sale of real property located in

COMMONWEALTH REGISTER VOLUME 20 NUMBER 02 FEBRUARY 1 5 , 1998 PAGE 15836

the Commonwealth, the sale of which was not in the course of carrying on a business in the amount of $75,000; [3] $1,000 gain from the sale of personal property not in the course of carrying on a trade or business; and [4] interest income from a savings account with a bank located in Guam in the-amiunt of $2,000. For this taxable year, Taxpayer M has income subject to the NMTIT in the amount of $128,000; income subject to the Wage and Salary Tax in the amount of $50,000; and income subject to the Earnings Tax in the amount of $38,500 [1/2 gain of $75,000 and $1,000 CNMI sourced gain]. For this taxable year, Taxpayer M is allowed to claim 2 personal exemptions and files a joint income tax return. M prepares his Form 1040CM for taxable year 1998 and determines the following:

Gross Income/Wages and Salaries/Earnings

Less: Personal Exemptions

Less: Standard Deduction

Taxable Income/Wages and Salaries/Earnings

Calculated Tax

Less: Non-Refundable Credits

Balance After Non-Refundable Credits

Less: Tax Withheld and Est. Tax Payments

Tax Withheld: $15,000.00 Est. Tax Payments: $5,000.00

$20,000.00

Tax Underpayment/ (Overpayment)

Calculation of Rebate Base (see below **)

Amount of Rebate Offset

$18,000.00 857.50 [$21,225] - [$20,000] x 70%

$(17,142.50)

AMOUNT DUE TAXPAYER:

CH 2 WST

$50,000.00

N/ A

N/A

50,000.00

4,500.00

N/'4

4,500.00

4,500.00

NM'lTE $1,805.00 Earnings Tax: 2,695.00 Rebate Offset: [17,142.50)

Due Taxpayer $(12,642.50)

** Rebate Base Allocation

Percentage of Income Within Subject to Rebate: 90% Within Subiect to Rebate: [$50,000] + [$75,000] + [$1,000]/$128,000 = 98%

Percentage of Income Without Not Subject to Rebate: 2% Without Not Subiect to Rebate: $2,000/$128,000 = 2%

Tax Imposed Within: $28,420.00 [$29,000] x [98%]

Less Non-Refundable Credits: (7,195.00)

Rebate Base $21,225.00

COMMONWEALTH REGISTER VOLUME 20 NUMB%R 02 FEBRUARY 15, 1998 PAGE 15837

* Note: Figures are for illustrative purposes only and thus personal exemptions, standard deductions, and other similar items have been estimated.

4. Sec. 2206.12(& Section 2206.12(g) is amended by deleting Example No. 3 in its entirety and replacing with the following:

Example No. 3. For taxable year 1998, individual Taxpayer A has revenues in the amount of $100,000 derived from sources within the Commonwealth in the course of carrying on a business. For this year, Taxpayer A has no other income, will file a joint income tax return, and will claim two (2) personal exemptions. Taxpayer A prepares his Form 1040CM for taxable year 1998 and determines the following:

Gross Income/Gross Revenues

CH 7 NMTIT CH 3 BGRT

$100,000.00 $100,000.00

Less: Personal Exemptions (4,000.00) N/A

Less: Standard Deduction (6,350.00) N/A

Taxable Income 89,650.00 lO0,OOO.OO

Calculated Tax 20,300.00 2,000.00

Less: Non-Refundable Credit (2,000.00) N/A

Balance After Non-Refundable Credit 18,300.00 2,000.00

Estimated Tax Payments Made 24,000.00 N/A

Tax Underpayment/(Overpayment) (5,700.00) 2,000.00

Calculation of Rebate Base: 18,300.00 N/A

Tax Imposed: $20,000.00 Less: Credit: (2,000.00)

Rebate Base: 18,300.00

Amount of Rebate Offset

AMOUNT DUE TAXPAYER

NMTIT: $(5,700.00) BGRT: 2,000.00 Rebate Offset: ( 16,470.00)

Amount Due (20,170.00)

**Note: Figures are for illustrative purposes only and, thus, figures used for personal exemptions, standard deductions, and similar items are estimates.

5. Sec. 2206.12 Section 2206.12 is amended by adding a new subsection (i) to read as follows:

(i) Transitional Rules. Pub. L. 10-74 amends rebate rates for taxpayers who are not corporations. Pub. L. 10-74 becomes effective on October 1, 1997.

f - Thus, the rebate rates under Pub. L. 9-22 for taxpayers who are not corporations


are in effect until September 30, 1997; the rebate rates under Pub. L. 10-74 are in effect after September 30, 1997. The provisions of this subsection apply to a taxpayer's 1997 taxable year; the provisions do not apply to post-1997 taxable years.

(1) Taxpayers With 1997 Taxable Year Ending; - December 31, 1997. Taxpayers with taxable years ended December 31, shall calculate their rebate under Pub. L. 9-22 for January 1,1997 until September 30,1997 and shall calculate their rebate under Pub. L. 10-74 for October 1, 1997 until December 31, 1997. Thus, 9/12 of a taxpayer's rebate shall be calculated under Pub. L. 9-22 and 3/12 shall be calculated under Pub. L. 10-74.

(i) Applicable Rebate Chart

TABLE A - January 1,1997 to September 30,1997

Amount of Tax Paid Level From To

C More than $1,875.00

Table B - October 1,1997 to December 31,1997

Amount of Tax Paid Level From To

C More than $25,000.00

Rebate Base

90% $675.00 plus 70% of rebate base over $750.00 $1,462.50 plus 50% of rebate base over $1,875.00

Rebate Base

90% $4,500.00 plus 70% of rebate base over $5,000.00 $18,500 plus 50% of rebate base over $25,000.00

(ii) Examples

(i). Example No. 1 If a taxpayer, with no nonrefundable credit, has records demonstrating that he or she paid $6,200 of NMTIT before 10/1/97 and $1,800 after 9/30/97, the taxpayer's rebate base is $5,245.00. This amount is calculated as follows: ($1,462.50) plus ($6,200 less $1,875 = $4,325)(50%) FABLE "A"] plus ($1,800.00) x (90%) =

$5,245.00 [TABLE "B"].

(2) Taxpayers - - With 1997 Taxable Years Ending After December 31, 1997. Taxpayers with taxable years ending after December 31, 1997,

COMMONWEALTH R E G I S T E R VOLUME 20 NUMIBR 02 FEBRUARY T 5 , 1998 PAGE 15839

shall calculate their rebate under Pub. L. 9-22 for the period of their 1997 taxable year that falls between January 1,1997 and September 30,1997; for the period that falls between October 1, 1997 and the last day of their taxable year, the rebate shall be calculated under P.L. 10-74. Thus, a taxpayer's rebate, under these circumstances, must be prorated similarly to as provided in subsection (1) above.

(i) Example No. 1. If a taxpayer's 1997 taxable year ends on November 30,1998, the taxpayer's entire rebate will be calculated under Pub. L. 10-74. This is so because each month in the taxpayer's 1997 taxable year (December 1997 through November 1998) falls after the effective date of Pub. L. 10-74.

(ii) Example No. 2. If a taxpayer's 1997 taxable year ends on September 30,1998, the taxpayer's entire rebate will be calculated under Pub. L. 10-74. This is so because each month in the taxpayer's 1997 taxable year (October 1997 through September 1998) falls after the effective date of Pub. L. 10-74.

(iii) Example No. 3. If a taxpayer's 1997 taxable year ends on June 30, 1998, 3/12 of the taxpayer's rebate will be calculated under the rates in effect in Pub. L. 9-22; 9/12 of the rebate will be calculated under Pub. L. 10-74.

111. REGS TO IMPLEMENT P. L. 10-80

1. Sec. 2202.1(b)(4). Sec. 2202.1(b)(4) is deleted in its entirety.

2. Sec. 2202.1(b) (5)-(6). Sec. 2202.1 (b)(5) and (6) are renumbered 2202.1(b)(4) and (5), respectively.

3. Sec. 2202.1(c). Sec. 2202.1(c) is amended by renumbering 2202.1(~)(11) as sec. 2201.1(~)(12).

4. Sec. 2202.1(c). Sec. 2202.1(c) is amended by adding new subsection 2202.1(~)(11) to read as follows:

(11) Interest, etc. Interest, dividends, rents, royalties, or similar income earned in and derived from a person in the

f\ -

COMMONWEALTH REGISTER VOLUME 20 N U M B ~ R 02 FEBRUARY 15, 1998 PAGE 15840

Commonwealth and received by a resident no in the course of carrying on a business.

5. Sec. 2206.12 Sec. 2206.12(b)(3) is amended by adding a sentence after the introductory clause and before section 2206.12(b)(3)(A) as follows:

Thus, taxpayers with interest with interest, dividends, rents, royalties, or similar income earned in and derived from a person in the Commonwealth and received by a resident not in the course of carrying on a business is not subject to rebate unless the individual elects to be subject to tax under 4 CMC section 1202 pursuant to 4 CMC section 1708(d)(2).

COMMONWEALTH REGISTER VOLUME 20 N U ~ % E R 02 FEBRUARY 15, 1998 PAGE 15841

PUBLIC NOTICE

NOTICE OF EMERGENCY ADOPTION OF AMENDMENTS TO THE RULES AND REGULATIONS GOVERNING THE HEALTH SCREENING REQUIREMENTS OF ALIEN EMPLOYEES

AND INTENT TO ADOPT AMENDMENTS TO REGULATIONS

Emerqency: The Secretary of the Department of Public Health of the Commonwealth of the Northern Mariana Islands finds that pursuant to the Commonwealth Code at 1 CMC §2603(a) and (b) the public interest requires the implementation and adoption on an emergency basis of amendments to the Rules and Regulations Governing the Health Screening Requirements of Alien

- Employees. The Secretary of Public Health further finds that it is in the best interests of the public that the amendments to the regulations become effective immediately upon concurrence by the Governor and the Office of the Attorney General and filing with the Registrar of Corporations. Once approved, the emergency amendments to the regulations shall remain in effect for a period of 120 days.

Reason for the Emerqencv: In February of 1997, the Rules and Regulations Governing the Health Screening Requirements of Alien Employees were adopted pursuant to the Administrative Procedures Act. Just prior to their implementation the Department of Public Health suspended the regulations at the request of the Office of the Governor. At the end of 1997, the Center for Disease Control

-(CDC) conducted a study on tuberculosis in the CNMI. The CDC's report, which was issued in January of 1998, indicates that the rate of tuberculosis in the CNMI has reached epidemic proportions. It is also a well known fact that the worldwide epidemic of tuberculosis and HIV are closely linked. Given the high risk for HIV transmission in the CNMI, the CNMl can expect a dramatic increase in HIV infected individuals in the near future, which will further exacerbate the CNMl tuberculosis epidemic. As a result of these findings, the Secretary of Public Health has determined that the public safety, health, and welfare mandates the immediate implementation of the Rules and Regulations Governing the Health Screening Requirements of Alien Employees in order to control the spread of communicable diseases such as tuberculosis and HIV among the alien employee population.

Contents: Attached to this Notice of Emergency are amendments to the health screening requirements for tuberculosis for alien employees and their dependents. These amendments are intended to simplify the procedure for

f -I screening for tuberculosis as well as ensure more accurate medical findings.

COMMONWEALTH REGISTER VOLUME 20 NUMBER 02 FEBRUARY 15, 1998 PAGE' 15842

Intent to Adopt: The Secretary intends to adopt these amendments to existing regulations as permanent regulations pursuant to 1 CMC 591 04(a)(l) and (2),

( and therefore publishes in the Commonwealth Register this notice of opportunity to submit comments. Copies of the amendments to the .~ules and Regulations may be obtained from the Office of the Secretary of Public Health located on the ground floor of the Commonwealth Health Center. Comments on the amendments to the Rules and Regulations may be sent to the Office of the Secretary of Public Health, Department of Public Health, P.O. Box 409 CK, Saipan, MP 96950. All comments must be received within thirty (30) days from the date this notice is published in the Cornmoqwealth Register.

Authority: The Department of Public Health is authorized to implement these amendments to the Rules and Regulations Governing the Health Screening Requirements of Alien Employees pursuant to 1 CMC $2603 and 52605.

Certified By: a -6-78 Date

Department of Public Health

- - Certification By Office of the Attorney General:

Pursuant to I CMC $21 53 as amended by PL 10-50, the proposed amendments to the rules and regulations attached hereto have been reviewed and approved

- - - - - -- s ncy by the CNMl Office of the Attorney Genera!.

Z [ W Q ~ Date

Concurred By:

Governor


Certified By:

Governor's Special Assistant For Administration

Received by: ~ o k a J. crdz // Governor's dfficg

a\l- Date

* Received by: Soledad B. Sasamoto Date Registrar of Corporations


Amendments to the Rules and Regulations Governing the Health Screening Requirements of Alien Employees

Sections 2.1 and 2.13 are hereby repealed in their entirety, and Section 2.19 is amended as follows:

Tuberculosis means a potentially communicable disease caused by the organism Mycobacterium tuberculosis, which may be diagnosed based on clinical, laboratory, radiological, and tuberculin skin testing. Active Tuberculosis is considered communicable and highly contagious.

The remaining definitions within Section II are hereby renumbered consecutively.

Section 4.4(a) is hereby repealed in its entirety, and amended as follows:

a. Tuberculosis Screening. Every Alien Employee shall obtain a single view PA chest radiograph upon entry into the CNMI, and then annually thereafter. The yearly test shall be performed at least forty-five (45) days prior to the annual renewal of the employment contract, or forty-five (45) days prior to the anniversary of the entry date into the CNMI, whichever date is first.

Section 7.1 (a) is hereby amended to read as follows:

a. Tuberculosis. Alien Employees found to have A&be Tuberculosis shall be required to comply with the Center for Tuberculosis and Lung Disease

- protocol for treating ktiw Tuberculosis for the duration of their stay in the CNMI.

. . Any Alien Employee diagnosed with Tuberculosis who does not comply with prescribed treatment and therapy for Tuberculosis, or who fails to comply with recommendations made by the Division may be referred by the Division to the Department of Labor and Immigration for Deportation.


NUTISIAN PUPBLIKU

NUTISIAN I GOTPE NA NISISIDAT INADAPTAN AMENDASION SIHA GI AREKLAMENTO YAN REGULASION

NI GUMUBEBETNA I AFUETSAON MAGEF ATAN HINEMLO' I TI MAN RESIDENTE NA EMPLEAO YAN I INTENSION PARA U MA ADAPTA I AMENDASION GI

REGULASION SIHA

G o t ~ e Na Nisisidat: I Sikretarion i Depattamenton Hinemlo' Pupbliku gi Commonwealth i Sangkattan siha na Islas Marianas ha sodda' sigon gi kodikon Commonwealth gi 1 CMC 92603 (a) yan (b), na i interest i pupbliku a afuetsas i implementasion yan inadaptan pot I ginetpe na nisisidat amendasion para I Areklamento yan Regulasion ni Gumubebetna I Afbetsaon Magef Atan Hinemlo' i Ti Man Residente na Empleao. I Sikretarion i Hinemlo' Pupbliku ha la sodda' na gaige itmas na interest i pupbliku na i amendasion gi regulasion siha u fanifektibu ensigidas gigon ha konfotma i Gubetno yan i Ofisinan i Abugaon Hinerat ya mana'fanhalom gi I Rehistran Kotporasion siha. Gigon ha' manrna'apmeba, i gotpe na nisisidat amendasion gi regulasion siha u fanefektibu para siento bente dias (1 20) na tiempo.

Rason Put i Gotpe Na Nisisdat: Gi Febreru mitnubesento nobentai siette (1997) na sakan, i Areklamento yan Regulasion ni Gumubebetna i Afuetasaon Magef Atan Hinemlo' i Ti Man Residente na Empleao ma adapta sigon i Macho'guen Dinirihi na Akto. Antes ha' di i emplimentasion ginen i Depattamento Hinemlo' Pupbliku, ha suspenda i regulasion ni ginagao I Ufisinan i Gubetno. Gi uttimon este na sakan (1 997)' i Sentron Mamanean Chetnot siha (CDC), ha kondukta i estudian i tibi na chetnot giya i Commonwealth i Sangkattan na Islas Marianas. Sigon i repot i Sentron para Marnanean Chetnot siha (CDC) ni malaknos gi Inem, mitnubesento nubentai ocho na sakan (1 988)' ha indidika na i sinisedin i chetnot tibi gi halom i Commonwealth Sangkattan na Islas Marianas ha fakcha'e epidemia na mineddong esta. Fakto lokkue gi bumalon tano' na i epidemian tibi yan i chetnot HIV na sumisiha'. Pot i tinatkilo' na tinatrnen i chetnot HIV gi halom i Commonwealth Sangkattan na Islas Marianas, sina ha' lokkue ta ekspekta i anchu na kina'hulo' i chetnot HIV ni siiia ha afekta unos quantos na indibiyuat siha gi man mamaila' na tiempo ni sifia ha' lokkue ha insima i epidemian tibi giya Commonwealth Sangkattan na Islas Marianas. Pues pot este na sineda', i Sikretarion i Depattarnenton i Pupbliku ha detetmina na i siguridat, hinemlo', yan adelanton I pupbliku ha ma manda na u guaha ensigidas na implementasion i Arelamento yan Regulasion ni Gurnubebetna i Magef Atan i Hinemlo' i Ti Man Residente na Empleao siha ya u otdin i inatahan i chinalapun yan tatatme na chetnot siha, tat komo i tibi yan i HIV gi halom i ti man

- residente na empleao gi populasion. --


Guinaha Siha: Checheton yan este na Nutisian Gotpe na Nisisidat ayu i ma amenda para i Magef Atan i Hinernlo' pot tibi ni para i- Ti Man Residente na Empleao yan i dependenten iiiha.

.- Este siha na amendasion ma intension para u simplifika i chachalan i magef atan i chetnot tibi . i yan lokkue para u mana' guaha dinanche na sine'da' i mediku. .

r

Intension Para U Adasta: I Sikretariu ha intensions para u adapk este siha na amendasion gi i eksisiste na regulasion komu petmanente na regulasion siha sigon gi 1 CMC 591 04 (a) 1 yan (2)' ya ginen ayu ha pupbliblika gi halom I Rehistran Commonwealth este na nutisia put appottunidat para muna'halom komento siha. Kopia sihs put este na amendasion gi Areklamento yan Regulasion siha, siiia manma chule' gifien i Ufisinan i Sikretarion Depattamenton Hinernlo' PupbIiku gi primet bibendan i Commonwealth Health Center. Komento siha put I amendasion gi Areklamento yan Regulasion siha, siiia mana'fanhanao guato gi Ufisinan Sikretarion Hinernlo' Pupbliku, Depattamenton Hinemlo' Pupbliku, P.O. Box 409 CK, Saipan, MP 96950. Todu komento siha debi di u fanma risibi gi halom trenta (30) dias despues di fecha ni ma pupblika este na nutisia gi halom i Rehistran Commonwealth.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . .-.. . . . . . . . . . -- . . . . - . - . . . . . . . . . .

Aturidat: I Depattamenton ine em lo' Pupbliku maiturisa para u implementa este siha na amendasion gi Areklamento yan Regulasion siha ni Gumubebetna i Afuetsaon i Magef Atan i Hinemlo' i Ti Man Residente na Empleao sigon gi patte 1 CMC 92603 yan 52605.

. .

i Ma Settefika as: J - L - ? ~ fecha

Depattamenton Hinemlo' . . . . ............. -..-..'........... -. -. . >. ................. -- -. Pupbliku. 7 "

Settefikasion i Ufisinan i Atbugaon Hinerat:

Sigon gi 1 CMC 02153 komu inamenda nu i Lai Pupbliku Numiru 10-5-, i priniponi siha na amendasion gi areklamento yan regulasion siha ni ma ton yan este

Tahguen Atbugaon Hinerat

Ma Konfitma as: Pedro P. 'l%norio fecha

Gubetno

COMMONWEALTH REGISTER VOLUME 20 NUMBER 02 FEBRUARY 15, 1998 PAGE

l?r$hcis Manibusan fecha Espisiat na Assistanten Gubetno para Adminstrasion

Ma risibi as: Donna J. C fech

Ma risibi as: &//3/7f Soledad B. SASAMOTO fecha

Rehistradoran Kotporasion siha

..... . . . _ . . . ....... . . . . . . . . . . . . . . . . . . . . . - - . . . . . -. .. - - . . .- . . . . . . . . . . . . . . . . i_..____ ... . . . . . . . . - . . . . . . --

i:..

, . ARONGORONGOL TOULAP n

i AKONCJ REEL IGHA EBWE GKAYIL ADOPTA LLI IWEL KKAAL NGALI ALLEGH K A A L IKKA E LEMELI META KKA EFIL REEL E B T E SCREEN-LIIE EMPLEYOW KKA SCHOOL LUGHUL (ALIEN EMPLOYEES) ME EBWE FEERULO SCHAGH ADOPTAAL LLIWEL KKAAL NGALI ALLEGH KKAAL.

Fmetnenc~: Sekeretera Bwulasiyol Public Health mellol Commonwealth Metawal W obl Faluw Kka Marianas e schuungi bwe sangi autol Commonwalth Code 1 CMC S 2603(a) me (b) bwe meta kka aghatchur aramas toulap efil ebwe yoor imolementasion me irdootasiop reel M i l smeraencv igha ebwe lliiwel allegh me aweewe reel lemelemil Health Screening Requirements reer emolevbw kka school lughul(alien emolovees). Sekereteri ebwal schuungi bve reel aghatchuur aramas toulap nge efil bwe lliiwel kkaal sdngi me1161 allCgh kkaal nge ebwe efektiibwo 16 ngkre schagh a appelOghdlb mereel Sbw Lemelem(Governor) bwal mereel Bwulasiyol Sow AlIegh(Attornev General) me ighan isisilong 1101 8-trar of Cor~orations. Ngare schagh a appelughulb. lliiwel - silngi melloi allCgh kkaal bwelle reel igha ebwe emereency nge ebwe efektiibwo 16 1101

- 1213 rhl.

Bvulul meta ebve emeraencv reel: L161 maram we hfailap(Februarv) 1161 ~ % g h we 1937. Allkgh kkaal reel Lemelemil e t c ee e u ' e e reer Emplev66w kka School Lughill(A1ien Emplo~ees) a adovted san gi autol aileewal Administration Procedures Act. Mmwal igha ebwe imolementaawov nge Bwulasiyol Public Health e

( ,, amweschli sef&ili allegh kkaal sangi tingbreeyal Rwulasiyol S6w Lemelem(Governor). Takke10611101 ragh we 1997, nge Center for Disease Control(CDC) e ayoora e s tud i~o reel semwaay ye TB.(Turberculosis) me1161 CNMI. Skngi yaal CDC riaood iye e toowow 1161 maramal Schoow( J a n u a n ) 1161 ragh ye 1998, e apasa bwe llapal TB.(Tuberculosis) me1161 CNMI a toori epidemic ~ rooor t ions weeweel bwe inamwo iya nge a yoor semwaay ye TB. me1161 m. Ebwal ghi ffat bwe inamwo iya mew601 faluw nge a yoor semwaay ye B. ebwal weewe schagh me m. Reel igha aghi llang t&elool HIV me1161 CNMI, iwe 1161 CNMI nge emmwal ebwe lapalo tee1661 semwaay ye U m e w o 6 r aramas 1101 riigh kka ebwe mwetto, ebwal weewe schagh reel ebwe bwal maas alapalapaalb semwaay ye tubercolusis me1161 CNMI. Bwelle reel alongal meta kka r e schuungi, Sekereteril Public Health a ditetmiinaav bwe bwelle reel yaar pobliko safetv, health. me welfare a afalafala bwe ebwe kkayil imolementaa~ Allegh me Aweewe ikka e Lemeli meta kka efil reel ebwe Screen-liir Emoliv6w kka Sch6bl LOghul(A1ien Emulovees) bwelle ebwe leghkty bwe essdbw teekkay semwaay kka e ti%& sibwe ira tubercolusis me HIV mew66r masemaseer emuliv66w kka School Lughul(A1ien Em~lovees).

Autol: Reel meta kka e appasch ngali Arongorongol Emerizencv nge ikkiwe a lliiwel bwelle reel mille health screening recluirements reel tuberculosis ngAliir emdivbw Bka sch66l IrSghOl(a1ien emdovees) me iyo kka yaar deuendents. Lliiwel kkaal nge ebwe maas mescheragh mwbghu tughutul screenin gal tuberculosis me ebwe bwal maas ayoora lo mmwal reel meta kka ebwe schuungi bwelle reel semwaay kkaal.

Efil Ebve Adoot: Sekereterie tipeli ebwe adootaav lliwel kkaal ngali allkgh kka ayoor hTe ebwe alligheld sdngi aileewal autol CMC § 9104(a)(l) me (21, iwe me ebwe

f - pohliikaalong 1161 Commonwealth Register Koviva reel Allegh me Aweewe kkaal nge emmwal ubwe bweibwogh mereel Bwulasiyol Sekereteril Public H e U iye elo Commonwealth Center. Aiyegh ngare Tiip reel Allegh me Aweewe nge emmwal ubwe afanga ngali Bwulasiyol Sekereteril Public Health reel, P 0 Box 409 CK. Saiuan MP 96950. Alongal aiyegh ngare tiip nge efil ebwe toolong 6 to l lb l eliigh(30) rB1 sangi yaal p6bliikaalonq I161 Commonweath Reaister


B w h g i l : Bwulasiyol Public Health eyoor bwbngil bwe ebwe imdemenbav alongal . , lliiwel kkaal ngiili A A e h kkaal ikka e Lemeli meta kka efil reel ebwe b e e n - l i n Emolivbw kka Sch66l LughOl(A1ien +. Emolovees).sangi auto1 aileeval CMC S 2503 ME 2605.

Appelligh mereel: 2-6 -78 Ral

AppelOgh mereel Bvulasiyol S6v AllBgh(Attotney General):

- Mereel 1 CMC S 2153 igha a lliiwel a g i a i l e e w a l L 10-50, pomwolil lliiwel kkaal reel all&gh$l me aweeweel iye e appasch ngdli nge a takkal amweri me alftgh0lOgh sdngi Bwulasiyol CNMI Attornev Generd. -

Loren Sutten ,' - -, Acting Attorney General

(-

.4lughulugh mereel.

S6w Lemeleml Governor)

Appelugh mereel: ~rancds Manibusan Governor's Special Assistance For Administration

Bwughiyal: Donna @k-4f& J. Cru Ral Bwulasiyol So L elem(Governor)

Bwu ghiyal Soledsd 8. Sasamoto RBI Registrar of Corporations

L -


PUBLIC NOTICE

NOTICE OF EMERGENCY ADOPTION OF AMENDMENTS TO THE RULES AND REGULATIONS GOVERNING

THE ADMINISTRATION OF THE MEDICAL REFERRAL PROGRAM AND INTENT TO ADOPT AMENDMENTS TO REGULATIONS

Emeraencv: The Secretary of the Department of Public Health of the Commonwealth of the Northern Mariana Islands finds that pursuant to the Commonwealth Code at 1 CMC 52605 the public interest requires the adoption on an emergency basis of amendments to Attachment 1 of the Rules and Regulations Governing the Establishment and Administration of the Medical Referral Program. The Secretary of Public Health further finds that it is in the - best interests of the public that the amendments to the regulations become effective immediately upon concurrence by the Governor and the Office of the Attorney General and filing with the Registrar of Corporations. Once approved, the emergency amendments to the regulations shall remain in effect for a period of 120 days.

Reason for the Emeraency: Since the implementation of the Rules and Regulations Governing the Establishment and Administration of the Medical Referral Program the Medical Referral Office and the Commonwealth Health Center physicians have determined that some sophisticated and complicated surgeries, such as infant heart surgeries and kidney transplants, cannot be performed without a significant amount of risk at the referral health care facilities listed in Attachment 1. The Medical Referral Office and the physicians have

-identified medical centers in the state of California that specialize in performing these sophisticated procedures. The Secretary of Public Health would like to expand the Medical Referral Program to encompass these California specialty medical centers.

In early to mid-1 997, the Medical Referral Committee approved medical referrals for several patients in need of emergency heart surgeries. As a result of medical complications, the Hawaii referral health care facility was unable to perform the surgeries and the patients were transferred to a California specialty medical facility for the surgeries. Although it was the intent of the Medical Referral Committee to have the Medical Referral Program cover these surgeries, the current regulations do no allow referrals beyond Hawaii. The amendments to the regulations will enable the Medical Referral Program and the Medicaid Office to provide financial assistance to these patients if and when they require follow up care, as well as facilitate the process for patients in need of complicated heart

t - surgeries in the future. Furthermore, there are currently patients waiting to undergo other such sophisticated surgeries that cannot be performed at the

.


existing referral health dare facilities. The bulk of the medical expenses for the surgeries will be covered by Federal programs, but these patients are in need of logistical and administrative support from the Medical Referral Office. The timing of these surgeries is critical to the health and welfare of the patients. The Secretary of Public Health has determined that enabling these surgeries to be performed through the Medical Referral Program will not only benefit the patients' long term health, but will also be cost effective for the CNMl Government.

Contents: Attached to this Notice of Emergency is the amended Attachment 1 to the Rules and Regulations Governing the Establishment and Administration of the Medical Referral Program. Attachment 1 has been modified to include referral health care facilities in California, as well as additional referral health care facilities in Guam and Hawaii.

Intent to Adopt: The Secretary intends to adopt these amendments to existing regulations as permanent regulations pursuant to 1 CMC §9104(a)(l) and (2), - and therefore publishes in the Commonwealth Register this notice of opportunity to submit comments. Copies of the amendments to the Rules and Regulations may be obtained from the Ofice of the Secretary of Public Health located on the ground floor of the Commonwealth Health Center. Comments on the amendments to the Rules and Regulations may be sent to the Office of the Secretary of Public Health, Department of Public Health, P.O. Box 409 CK, Saipan, MP 96950. All comments must be received within thirty (30) days from the date this notice is published in the Commonwealth Register.

Authoritv: The Department of Public Health is authorized to implement these amendments to the Rules and Regulations Governing the Establishment and Administration of the Medical Referral Program pursuant to 1 CMC 52605.

-

Certified By: Date

Department of Public Health


. .

Certification By Office of the Attorney General:

Pursuant to 1 CMC s2153 as amended by PL 10-50, the proposed amendments ( to the rules and regulations attached hereto have been reviewed and approved

ncy by the CNMl Office of the Attorney General.

I

Concurred By:

Governor

Certified By: rand is Manibusan

% Date

Governor's Special Assistant For Administration

.- I .

Received by: Date

Soledad 6. Sasamoto Registrar of Corporations

Date

COMMONWEALTH R E G I S T E R VOLUME 20 NUMBER 02 FEBRUARY 15, 1998 PAGE 15853

For purposes of these Rules and Regulations, the following health

care facilities, and those health care providers and ancillary care providers

associated with these facilities, shall be recognized as "referral health care

facilities" for medical referral patients from the CNMI:

Territorv of Guam

Dededo Polymedic Clinic Espaldan Clinic, Inc. Family Medical Clinic

Good Samaritan Clinic Guam Memorial Hospital

Guam Pacific Medical Clinic Guam Seventh Day Adventist Clinic

Specialty Clinic

St. Anthony Clinic The Doctor's Clinic

Cancer lnstitute of Guam Naval Hospital Guam MR Imaging Group Guam Eye Clinic Guam Public Medical Clinic -

State of Hawaii

Kapiolani Medical Center Kuakini Medical Center Queen's Medical Center

Rehabilitation Hospital

S hriner's Hospital For Crippled - Children

St. Francis Medical Center

Straub Clinic and Hospital

Cancer Institute of Maui Renal Treatment Center Tripler Army Medical Center Island Cardiology Kahi Mohala

Republic of the Phili~pines

State of California Makati Medical Center

*San Diego Children's Hospital Saint Luke's Medical Center

*California Pacific Medical Center Philippine General Hospital

State of Texas *The Brown Schools of Central Texas

(San Marcos Treatment Center, Health Care Rehabilitation Center, etc.)

*Referral to these referral health care facilities shall be authorized only for infant heart surgery, kidney transplants, or other highly sophisticated surgical

procedures as substantiated and approved by the Medical Referral Committee. t. -


NUTISIAN PUPBLIKU

NUTISIAN I GOTPE NA NISISDAT INADAPTAN AMENDASION SIHA GI AREKLAMENTO YAN REGULASION NI GUMUBEBETNA I

ATMINISTRASION I PRUGRAMAN RINIFEREN MEDIKU YAN I INTENSIONA PARA U MA ADAPTA I AMENDASION GI

REGULASION SIHA

Gotpe Na Nisisidat: I Sikretarion i Depattamenton Hinemlo' Pupbliku gi Commonwealth i Sangkattan siha na Islas Mariana ha sodda' sigon gi Kodikon Commonwealth gi CMC $2605, na i interes pupbliku ha nisisita i inadapta i amendasion siha gi gotpe na nisisidat na manera guato -g i Nina'chetton 1 gi Areklamento yan Regulasion siha ni gumubebetna i Inestablesi yan Inadministrasion i Programan Riniferen Mediku. I Sikretarion Hinemlo' Pupbliku ha sodda' mas na gaige gi etmas maolek na interes pupbliku na i amendasion gi regulasion siha u fanifektibu ensigidas gigon ha aprueba i Gubetno yan i Ofisinan i Abugaon Hinerat ya mana'fanhalom gi halom i Rehistran Kotporasion siha. Gigon ha' manma'aprueba, i gotpe' na nisisidat amendasion gi regulasion siha u fanefektibu para 120 dias na tiempo.

Rason Put I G o t ~ e Na Nisisdat: Pu t i i m p l i m e n t a s i o n i Areklamento y a ~ " Regulasion siha ni gumubebetna i Inestablesi yan Inatministrasion i Prugraman Riniferen Mediku, i Ufisinan Riniferen Mediku yan i Medikon Commonwealth Health Center siha ma ditetmina na guaha siha mansofistika yan komplikao siha na operasion, tat komu operasion korason neni yan trinansplantan riiion siha ti siiia na u fanmacho'gue sin i siknifikante na kantidan piniligru gi ma riferi guato na fasilidat inadahen hinemlo' ni manma lista gi Nina'chetton 1. I Ufisinan Riniferen Mediku yan i dokto siha esta ma identifika sentron mediku siha gi halom California ni ma espesiatlisa gi ma cho'guen este siha na mansofistikan uperasion. I Sikretarion Depattamenton Hinemlo' Pupbliku malago' na u aomenta i Prugraman Riniferen Mediku ya u embrasa este siha na spesiatamenten sentron medikon California.

Gi tutuhon asta i talo' na patte gi 1997, i Riniferen Mediku na komite ha - aprueba riniferen onos kuanto siha na manmalango ni ma nisisita ensigidas


na uperasion korason siha. Komu resutton komplikasion minalagnu, i , . , . fasilidat inadahen hinemlo na fasilidat Hawaii ti ma na'sifia chumo'gue i

uperasion siha ya i manmalangu manmatransferi guato gi i espesiatamente na fasilidat mediku gi California para i uperasion siha. Maseha ayu intension-iia i Rinifern Mediku na Komite i para u nafanmakubre este siha na uperasion ni Prugraman Riniferen Mediku, i prisente siha na regulasion ti ma sedi riniferi siha mas chago' ki Hawaii. I amendasion siha gi regulasion siha siempre u na'siiia i Prugraman Riniferen Mediku yan i Ufinsinan Medicaid para u pribeniayudon salappe' para este siha manmalangu yanggen yan gi anai ma nisisita follow up care, parehu ha yan para u fanma kalamtini i manmalangu siha ni munisisita komplikao na uperasion korason gi manmamaila' siha na tiempo. Put mas, guaha siha manmalangu gi prisente manmananangga ni para otro mas siha na mansofistikat na uperasion ni ti mansifia manma cho'gue gi prisente na fasilidat manriferen inadahen hinemlo'. Memeggaifia gi gaston medikat para uperasion para u fanmakubre nu i prugraman Federat siha, lao este siha na manmalangu ma nisisita supottan petsonat yan atministrasion ginen i Ufisinan Riniferen Mediku. I tiempo ni para u fanma cho'gue este siha na uperasion manggof kritikat para i hinemlo yan minaolek i manmalangu siha. I Sikretarion Depattamenton Hinemlo' Pupbliku ha

\. ditetmina na i para u fanmasedi este siha na uperasion entre i Prugraman Riniferen Mediku ti para u benifisiu ayu ha' i anakko' na tetminon hinemlo' i manmalangu siha , lao para u efektibu gi gaston para i Gubetnamenton CNMI lokkue'.

Guinaha siha: Chechetton gi este na Nutisian Gotpe na Nisisidat ayu i ma amenda na Nina'chetton 1 gi Areklamento yan Regulasion siha ni Gumubebetna i Inastablesi yan Inatministrasion i Prugraman Riniferen Mediku. I Nina'chetton 1 este ma modfika ni para u engklusu fasilidat para riniferen inadahen hinemlo giya California, kontodu adisionat na fasilidat para riniferen inadahen hinemlo' siha giya Guam yan Hawaii.

Intension para u Adapta: I Sikretariu ha intensiona para u adapta este siha na amendasion gi i eksisiste na regulasion komu petmanente na regulasion siha sigon gi lCMC $9104(a)(l) yan ( 2 ) , ya ginen ayu ha pupbliblika gi halom i Rehistran Commonwealth este na nutisia put apottunidat para muna'halom komento siha. Kopia siha. put este siha na amendasion gi Areklamento yan Regulasion siha sifia manma chule' ginen i Ufisinan i Sikretarion Depattamen ton Hinemlo' Pupbliku gi primet

. - bibendan i Commonwealth Health Center. Komento siha put i amendasion


gi Areklamento yan Regulasion siha siiia mana'fanhanao guato gi Ufisinan Sikretarion Hinemlo' Pupbliku, Depattamenton Hinemlo' Pupbliku, P.O. Box

i 409 CK, Saipan, MP 96950. Todu komento siha debi di u fanma risibi gi M o m trenta (30) dias despues di fecha ni ma pupblika este na nutisia gi halom i Rehistran Commonwealth.

Aturidat: I Depattamenton Hinemlo' Pupbliku ma aturisa para u implementa este siha na amendasion gi Areklamento yan Regulasion siha ni Gumubebetna i Inestablesi yan Inatministrasion i Prugraman Riniferen Mediku sigon gi 1 CMC $2605.

Ma Settefika as: a -6-TB Fecha

Depattamenton 'Hinemlo Pupbliku

. Settefikasion i Ufisinan i Atbugaon Hinerat:

Sigon gi t CMC $2153 komu inamenda nu i Lai Pupbliku Numiru 10-50, i priniponi siha na amendasion gi areklamento yan regulasion siha ni

.rnaiiechetton y a n este guini esta manina yan aprueba komu fotma yan sanu gi ligat nu i Ufisinan Atbugaon Hinerat CNMI.

Loren Sutton Tahguen Atbugaon Hinerat

Fecha

Ma Konfitma as: Pedro P( Tenorio Gubetno


Ma Settefika as: ~ r y n c i s Manibusan Fecha Espesiat na Assistanten Gubetno para Atministrasion

Ma risibi as: %->$. ,

Donna J. Fecha Ufisinan ube no

Soledad B. SAsAMoTo Fecha Rehistradoran Kotporasion siha -

-- - - - - ,


ARONGORONGOL TOULAP

I' AKONGORONGOL REEL IGH A EBWE EMERGENCY ADOPT1 ONUL LLIIWEL KKAAL NGALI A L L ~ G H KKAAL IKKA E LEMELI

MINISTRASIONUL MEDICAL REFERRAL PROGRAM ME IGHA EFIL EBWE ADOPT LLIIWEL KKAAL BWE ALLEGHUL.

Emer~ency: Sekereteril Bwulllrsiyool Public Health me1101 Commonwealth Metawal Wodl FalrZw Kka Marian* e schuungi bwe sa;ngi mellbl auto1 aileewal Commonwealth Code 1 CMC S 2505 bw-c meta kka aghatchuur aramas toulap nge efil ebwe a d o ~ t 1101 -- emereency basis reel lliiwel kkaal mereel attachment 1 sangi alleghul me aweeveel ikka e lemeli ffeeretAA1 Administrasionu 1 Medical Referral Pronram. Sekereteril Public Health ebwal maas schuuagi 16 mmwal bwe reel aghatchuur aramas toulap nge efil bwe lliiwel kkaal s h g i me1101 allkgh kkaal ebwe efektibwo 16 ngare schagh Sliw Lemelem(Governor) a a10ghBlOgh01 bwal siingi Bwulasiyol S6w AlICgh(Attornev General) me ebwe isisilong R e g i s t r a r Ngare schagh a appelughulo lliiwel kkaal sdngi mellol allegh kkaal reel igha ebwe smergencv nge ebwe afektibwo lrj 1161 120 rB1.

BvulQl meta ebve emeraencv reel: Sangi reel im~lementasionul Allkgh kkaal ilrka e lemeli ffeeretaA1 me Administrasionul Medical Referral Prorram. Medical !?efwrd Procram me Commonwealth Health Center physicians r e ditetmiinaav bwe eyoor akkaAw meta kka a-eirsil ~ u r ~ e r i e s , sibve ira surneries reel. korasoneer gh66gho me kidney transalant, tapp kkaal nge ese mmwal bwe ebwe ffeere16 schagh

(.. bwelle igha e awweiris me1161 fasilidobdul referral health care ikka e listatiw mellol Attachment 1. Medical Referral Office me physician kkeey r e filiitii medical center ye elo state of California hwe igha r e angaghatch reel rebwe fberu tappal awweirasil angaang yeel. Sekereteril Public Health emwuschal ebwe alapalapaalo Medical Referral Prorram bwe ebwe bwal fitilong California suecialtv centers.

Ragh &ewe me 6tol 1161 ragh ye 1997, Medical Referr& e aareebaav medical referral nxbliir akkitdschey malesemwaay kka r e fil bwe rebwe 16 faal emergency heart surgeries. Sangi toowowul medical nge eghi avweirds. Fasilido6dul Hawaii referral health care ese bwzing ngali ebwe feeru ~ u r n e r i e ~ iwe malesemwaay r a afangaarelo California suecialty medical facilitv bwe rebwe feeru surueries. Tipeer Medical Referral Committee bwe ebwe yoor medical referral uroaram iye ebwe bwang ngali reel tappal tittil kkaal, iyeey reel all&ghOl nge ese mweiti ngkli referral reel ebwe afangaar maas lo mmwal Hawaii. Reel lliiwel kkaal ngali allegh kkaal ebwe alisi Medical Referral P r o n r m me Bwulasiyol Medicaid bwe ebwe ayoora alillisil salaaui nghliir malesemwaay ngare me igha efil bwe rebwe 16 maas amweriild meta ye rebwe ghatch reel. ebwal weewe schagh me igha rebwe feeru n g d i i r malesemwaay kka e axweir& semwaayur sibwe i r a tittilil korason 1161 mwetelo mmwal. Bwal akkaziw, eyoor iyeey malesemwaay kka r e w e m e t i alillis reel tappal awweirbil tittil(surneries) kkaal ikka ese hwang ngali referral health care f w . . . ighila. Reel lapalapal abwos reel reel tappal tittil yeel nge ebwe yoor alillis s h g i Federal Proarams,iwe malesemwzty kkaal nge efil rebwe amweri lapalapal alillis sangi Bwulasiyol Medical Referral. Gruurul tappal tiltil kkaal nge eghi ammwung ngali yaal health me welfare m k s e m v a y . Sekereteril Public Health a ditetmiinaav reel ebwe tepengi tittil [wrrenes~ k h ? l reel igha ebwe bwal laalfiy lo yaar health malesemwaay. nge ebwe 1;-val ghatch abwos reel igha ebtve ba-ang ngali gohenamentool CNMI.


AUTOL: Sekereteri e tipeli ebwe adoot-lil lliiwel kkaal n gali alle gh kka ayoor ighila. bwe ebwe llegheJ6 allegh kkaal s h g i aileewal 1 5 9104ia)( 1) me ( 2 ) me ebwe toolong arong yeel me1161 m n w e a l t b Regist= reel igha ebve yoo isisilongol aiyegh ngare tiip. K o D ~ v ~ ~ lirarel kkaai ngdli allgh kkaal nge emmwel ubwe bweibwogh mereel Bwulasiyol Commonwealth Health Center Aiyegh . . ngare tiip ngdli lliiwel kkaal nghli allegh kkaal emmval ebwe akafang ngW m a 1 Sekereteril Public H e m Bwulasiyol Public Health. P.O.Box: 409 CK. Saioan M P 96950 Alongal aiyegh ngare tiip nge ebwe toolong btol 1161 eliigh(30) rhl s b g i rill La e toolong arong yeel f1&1 ~ammonwealth Register.

/ BWANGIL: I3wulasiyol Public Health eyoor bwangil reel ebwe fekrul lliiwel kkaal ngali -4lkgh Lkaal ikka e lemeli ffekretaal me Administrasional Prorroomal Midecal EeferraI sang1 aileewal 1 W S 2M5.

Xppelugh merel:

AppelLgh mereel B ~ u l a s i y o l S 6 r All&gh(Attorney General)

S h g i 1_CMC S 2153 igha a lliiwel mereel aileewal& 10-50, Pomwol Lliiwel kkaal ngiili AllCgh kkaal ikka e appasch ngiili a takkal amweri me alOgh01Qh reel igha ebwe ffherelb me lleghbfisch 16 s h g i Bwulasiyol Sow Allegb( Attorney General).

ELLIOTT. A; SATT.LER--- - - .

Loren Sutton Acting Attorney General - Alughriliigh By:

Appelugh mereel: ~t(adcis Manibusan Governor's s pecial i i i is lan t e ~ n i s t r a t i o n . /

Appelugh mereel: Soledad B. Sasamoto Registrar of Corporation

COMMONWEALTH R E G I S T E R VOLUME 20 NUMBER 02 FEBRUARY 15, 1998 PAGE 15860

PUBLIC NOTICE

PROPOSED AMENDMENTS TO THE SCHEDULE OF FEES DEPARTMENT OF PUBLIC HEALTH

Title I CMC Division 2, Chapter 12, and in particular 1 CMC §2603(f) and 2605(j), provides that the Secretary of the Department of Public Health (DPH) shall administer all government owned facilities and shall implement rules and regulations for the efficient delivery of health services in the CNMI.

Pursuant to this authority, the Secretary is amending specific fees from the Schedule of Medical and Other Related Fees which was published in its entirety, and adopted, in the Commonwealth Register Volume 17, Number 2, dated February 15, 1995 and Volume 17, Number 4, dated April 15, 1995, respectively. These amendments are necessary to reflect accurately in the Schedule of Medical and Other Related Fees the types of services that are now being provided by the Department. The amendments are attached herewith and will be incorporated into the DPH Schedule of Medical and Other Related Fees upon

i adoption.

In adopting these Amendments to the Schedule of Fees, it is the intention of the Department of Public Health to comply with the requirements of the Administrative Procedure Act, specifically 1 CMC S9104. Copies of the proposed Amendments to the Schedule of Fees may be obtained from the Office of the Secretary of Public Health located at the ground floor of CHC. Comments on the proposed Amendments to the Schedule of Fees may be sent to the Office of the Secretary of Public Health, P.O. Box 409 CK, Saipan, MP 96950. All comments .must be received within 30 days from the date this notice is published in the Commonwealth Register.

Certified By: + -Public Health

Filed Byc .

SOLEDAD B. SASAMOTO Registrar of Corporations

2//7/?8' DATE


Received By: DATE

Acting SAA Governor's Office

Pursuant to 1 CMC $2153 as amended by PL 10-50 the rules and regulations attached hereto have been reviewed and approved by the CNMl Attorney General's Office.

Dated this !%%aY of February 5 ,998.

Sally 9. Pfung


NUTlSlAN PUBLIKU

PRlNUPONl SlHA NA AMENDASION GI LISTAN APAS DIPATTAMENTON HINEMLO' PUBLIKU

I Tituilu I gi Kodikon Commonwealth (CMC) Dibision 2, Kapitulu 12 yan patikulatmente i 1 CMC s2603(f) yan 2606(j), ha pribebeni i Sikritarion Dipattamenton Public Health (DPH osino' Dipattamenton Hinemlo' Publiku, na para guiya u atministra todu fasilidat gobetno siha yan u enfuetsa todu areklamento yan regulasion siha para minaolek mana'en setbision hinemlo' gi halom i (CNMI) lslas Marianas.

Sigun gi este na aturidat, i Sikritariu ha amemenda espisifiku siha na presiu ginen i lista put mediku yan otro siha apas (Schedule of Medical and Other Related Fees) ni ma publika gi entieru-na, yan ma adapta, gi Rehistran Commonwealth, Volume 17, Numeru 2, gi Febreru 15, 1995 yan Volume 17, Numero 4, gi Abrit 15, 1995. Prisisu este siha na amendasion gi listan presiu siha put mediku yan otro siha apas put para u riflekta i dinanche siha na klasin setbisio ni ma pribeni gi dipattamento. I amendasion mandadana sigun este na notisia ya u ma na patte gi lista put mediku yan otro siha apas (Schedule of Medical and Other Related Fees) gi depattamento gi ma adaptanna.

Gi ma adaptanna este siha na amendasion gi listan presiu siha, ha entensiosiona i Dipattamenton Hinemlo' Publiku kumumple i kondesion siha ni manma' establesi nu i "Administrative Procedure Act" na akto, espesiatmente i 1 CMC ~9104. Kopia siha put i manma prupoponi na amendasion gi Listan Apas siha sina manmachuchule' gi Ufisinan i Sikritarion Hinemlo' Publiku gi primet bibenda gi CHC. Dokomento siha put i manma' prupoponi na amendasion gi Listan Apas sina mana' fanhahanao guato gi: Office of the Secretary of Public Health, P.O. Box 409 CK, Saipan, MP 96950. Todu dokomento siha debi di u fanma risibi gi halom trenta (30) dias despues di i fechan ni publika este na nutisia gi Rehistra Commonwealth.

Mas settefika nu as: -%%-

Ma Rikot nu as: SOLEDAD B. SASAMOTO Fecha Registrar of Corporation

Ma Resibi as: ~rahc$s Manibusan, Acting SAA

a) I 91% Fecha

~ovehor 's Office


DEPARTMENT OF PUBLIC HEALTH AMENDMENT TO THE SCHEDULE OF MEDICAL

AND OTHER RELATED FEES LABORATORY SERVICES

CPT SHORT DESCRIPTION

Electrolytes (Sodium, Potassium, Chloride, C02) Chem 7: Automated Multichannel Test (Must include: Electrolytes, Glucose, BUN, Creatinine) Chem 12: Automated Multichannel Test (Must include: Electrolytes, Glucose, BUN, Creatinine, AST, Calcium, Alkaline Phosphatase, Albumin,Total Bilirubin) Liver Profile: Hepatic Function (Must include: Alkaline Phosphatase, Total Protein, Albumin, AST, ALT, Total and Direct Bilirubin) Lipid Profile: (Must include: Cholesterol, Triglycerides, HDL, calculated LDL) Thyroid Profile 1 (Must include: Thyroxine, Tuptake) Thyroid Profile 2 (Must include: Thyroxine, Tuptake, TSH) Carbamazapine Digoxin Gentamicin Phenobarbital Phenytoin (Dilantin) Salicylate Theophylline Urinalysis (by dipstick or tablet reagent for bilirubin, glucose, hemoglobin, ketone, leukocytes, nitrite, pH, protein, urobilinogen, specific gravity, any number of these; non-automated with microscopy) Urinalysis (above without microscopy) Volume measurement (for timed collection, urine)

AMOUNT (IN US $1

$30.00

$35.00

$45.00

$40.00

$35.00

$30.00

$55.00

$30.00 $30.00 $30.00 $30.00 $30.00 $35.00 $30.00 $1 5.00

$1 2.00

$1 0.00


Urinalysis, microscopic only Beta HCG (Urine pregnancy test, qualitative) Acetaminophen

Acetone (or other ketone bodies, serum, qualitative) Ibumin, serum Microalbumin, urine Alcohol (Ethanol) Amylase Bilirubin (Total or Direct) Bilirubin (Total and Direct) Occult Blood, Fecal Screen (1 -3 simultaneous determinations) Calcium Calcium, Urine quantitative (timed specimen) Chloride Chloride, Urine Cholesterol Creatine Kinase CKMB isoenzyme Creatinine, Serum Creatinine, other source Creatinine Clearance Ferritin Glucose Glucose, post dose glucola Glucose tolerance (includes first three specimens) Glucose tolerance (each additional test beyond first three) Gamma GT FSH LH Hemoglobin AIC/Glycohemoglobin ron Iron Binding Capacity LDH Magnesium Alkaline Phosphatase Phosphorous Phosphorous, Urine Potassium


Potassium, Urine Prolactin PSA Protein, Total (all sources) Sodium Sodium, Urine Thyroxine, Total TSH AST ALT Triglycerides BUN Urea Nitrogen, Urine Uric Acid Uric Acid, Other Source Beta HCG, Quantitative Beta HCG (Serum pregnancy test, qualitative) Bleeding Time Spun Microhematocrit Hematocrit Hemoglobin CBC with manual differential CBC with automated differential CBC no differential Reticulocyte count WBC only Blood Smear, peripheral (interpretation by physician with report) Fibrinogen Degredation Products Fibrinogen Platelet Count Protime ESR (sed rate) aPTT, Partial Thromboplastin Time AS0 titer AS0 screen Investigation of Transfusion Rxn ~ e v i a t b n from Standard Blood Bank Protocol $30.00 (pathologist review with written report) Cold Agglutinin, Titer $25.00 Monospot $1 4.00 Rheumatoid Factor, qualitative $1 5.00 Rheumatoid Factor, titer $20.00 RPR $1 5.00


Rubella Screen $25.00 Antibody Screen (Blood Bank) $20.00 DAT (Direct Coombs) $20.00 Blood Group, ABO $1 5.00 Blood Type, Rh $ 6.00 Compatibility Test each unit $1 5.00

(immediate spin) Compatibility Test each unit $1 5.00 (incubation technique) Splitting of Blood or Blood Product $1 8.00 (each unit) Blood Culture $35.00 Stool Culture $30.00 Throat Culture $20.00 Culture, Other Source $30.00 Organism Identification $1 0.00 (any source except urine, by commercial kit) Culture, Anaerobic $30.00 Culture $1 5.00 (Single Organism Screen) Culture $1 5.00 (presumptive pathogen, screen by commercial kit) Urine Culture Organism ldentification (Urine, commercial kit) Organism ldentification (Urine, method other than commercial kit) Culture, Fungal (skin) Culture, Fungal (other) Culture, Fungal (blood) Fungal ldentification each organism Serological Typing (agglutination, each antisera) Additional ldentification Method (any culture source) 0 and P, Complete MIC (Sensitivity) Smear, primary source, routine stain (Gram) Wet mount smear Stool for WBC KOH smear Clostridium difficile toxin assay Hepatitis B Surface Antigen (HbsAg)


Cell Count (other body fluid, except blood) Above with differential Crystals, exam and identification Nasal smear for eosinophils Semen Analysis, Post Vasectomy Semen Analysis, Complete Transfusion, each unit Special Handling Therapeutic Phlebotomy Stat fee per testlpanel Venipuncture Fee

/

t, -


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