* OPEN LETTER TO SECRETARY OF HHS: ROBERT F. KENNEDY Jr. Regarding Patient Harm & Fiscal Disfunction at CHCC, CNMI-USA*

CNMIGA .ORG
18 hours ago
4 min read

Urgent Demand for Forensic Investigations into Commonwealth Healthcare Corporation (CHCC)

To: The Trump Administration and Secretary Robert F. Kennedy Jr.

Date: July 15, 2025

Subject: Immediate Forensic Investigations and Accountability at CHCC

Introduction

We at CNMIGA.ORG, representing concerned citizens and advocates for transparency, accountability, and the protection of American patients, demand immediate forensic investigations into the Commonwealth Healthcare Corporation (CHCC) in Saipan, Northern Mariana Islands (NMI). For decades, CHCC has engaged in practices that harm American patients, defraud taxpayers, and exploit federal resources, as evidenced by audits, reports, and open-source data. This comment outlines the systemic failures necessitating federal intervention and cites applicable laws and regulations to enforce accountability.

Grounds for Investigation

1. Patient Harm by Unqualified Foreign Workers

CHCC’s reliance on foreign medical workers from non-American accredited institutions has caused documented patient harm. The Report on the Necessity of Federal Receivership for CHCC (June 9, 2025) notes that these workers, often lacking English proficiency, contribute to medical errors, misdiagnoses, and surgical mistakes. Patient testimonials corroborate these findings, highlighting violations of 42 U.S.C. § 1395, which mandates adequate safeguards for patient care under Medicare standards. The JANUARY 11, 2024 MINUTES reveal approvals of foreign locum staff (e.g., Dr. Sabine Kelischeek, Dr. Mohammad Hasssein) without evidence of U.S. accreditation, exacerbating risks to indigenous American patients.

Demand: Cease employment of unqualified foreign workers and mandate that all medical staff graduate from American-accredited schools in good standing, per 42 CFR § 482.22, requiring competent staffing.

2. Fraud, Waste, and Abuse of Federal Funds

Audits reveal CHCC’s systemic financial mismanagement. The Treasury OIG Report (2023) identified $11.1 million in questioned costs from federal block grants, while the CHCC FY 2019 Compliance Report (Findings 2019-004 to 2019-016) documents material weaknesses in internal controls, including unsupported expenditures. The CNMI Visa Crisis Report notes $20 million in FEMA funds diverted post-Typhoon Yutu, violating 31 U.S.C. § 7501 (Single Audit Act). These practices defraud American taxpayers, contravening 18 U.S.C. § 371, which prohibits conspiracy to defraud the United States.

Demand: Conduct a forensic audit of all federal funds since 2008, as authorized under 31 U.S.C. § 7502, to recover misallocated resources and impose penalties.

3. Executive Staff Enrichment Amid Patient Suffering

While CHCC owes $85 million to the Commonwealth Utilities Corporation (CUC) per House Bill 24-49, executive staff have received pay raises, prioritizing personal wealth over patient care. The CHCC FY 2024 Citizen-Centric Report highlights investments in equipment, yet patient outcomes remain poor, indicating misprioritization. This breaches the fiduciary duty under 42 CFR § 482.12, requiring hospital governance to ensure quality care.

Demand: Freeze executive salaries until CHCC achieves financial stability and meets patient care standards, enforceable under 42 U.S.C. § 1395dd.

4. Refusal to Carry Malpractice and Liability Insurance

CHCC’s lack of malpractice and liability insurance deviates from U.S. healthcare norms, endangering patients and staff. The Report on the Necessity of Federal Receivership underscores this gap, violating the implied duty of care under 42 U.S.C. § 1395 and exposing CHCC to legal risks under tort law (Restatement (Second) of Torts § 323).

Demand: Mandate full medical malpractice and liability insurance, tied to federal funding eligibility under 42 CFR § 482.11.

5. Burden on American Taxpayers

CHCC’s refusal to address its $85 million debt, coupled with reliance on federal bailouts (e.g., $50 million in grants since 2008 per CNMI Visa Crisis Report), burdens American taxpayers. The Public Law No. 23-09 document reveals the CNMI government’s failure to remit $8.6 million in FY 2023 Medicaid funds, further straining CHCC. This violates 31 U.S.C. § 6301, ensuring fair use of federal assistance.

Demand: Enforce a repayment plan for the $85 million debt, per 31 U.S.C. § 6305, and halt federal funding until compliance is achieved.

6. Failure to Develop Sister-State Programs

CHCC’s refusal to partner with American hospitals and schools, opting instead for non-English-speaking foreign workers, undermines care quality. The Report on the Necessity of Federal Receivership highlights this neglect, contravening HRSA guidelines for improving healthcare access through collaboration.

Demand: Establish sister-state programs with U.S. institutions, mandated under 42 U.S.C. § 254b, to ensure qualified American staff.

Evidence of Decades-Long Fraud

The CHCC FY 2019 Compliance Report reveals a pattern of noncompliance with federal regulations, with findings (e.g., 2019-001 to 2019-016) spanning general ledger issues, inventory mismanagement, and procurement violations. These issues, repeated from prior audits, indicate a decades-long scheme to defraud taxpayers, necessitating forensic scrutiny under 31 U.S.C. § 7503.

Legal Basis for Action

42 U.S.C. § 1395: Ensures patient care safeguards, violated by CHCC’s staffing and insurance practices.

18 U.S.C. § 371: Criminalizes fraud against the U.S., applicable to federal fund misuse.

31 U.S.C. § 7501: Requires audits and accountability for federal awards, breached by CHCC’s weak controls.

42 CFR § 482: Sets hospital participation conditions, unmet by CHCC’s staffing and governance failures.

Case Law: Darling v. Charleston Community Memorial Hospital (1965) establishes hospital liability for staff competency, supporting our demands.

Specific Demands

Forensic Investigations: Launch an independent investigation by the Office of Inspector General (OIG) or Government Accountability Office (GAO) into CHCC’s finances, staffing, and patient care, per 31 U.S.C. § 7502.

Stop Unqualified Foreign Workers: Prohibit hiring from non-American accredited schools, enforcing 42 CFR § 482.22.

Mandate Insurance: Require full malpractice and liability coverage, per 42 CFR § 482.11.

Audit Prescription and Equipment Budgets: Investigate expenditures for fraud, under 31 U.S.C. § 7503.

Establish Sister-State Programs: Mandate U.S. partnerships, per 42 U.S.C. § 254b.

Financial Accountability: Enforce debt repayment and freeze executive salaries, per 31 U.S.C. § 6305.

Conclusion

CHCC’s actions—patient harm, fraud, executive enrichment, and refusal to adopt U.S. standards—demand immediate federal action. We call on the Trump Administration and Secretary Robert F. Kennedy Jr. to protect American patients and taxpayers by initiating these investigations and reforms. Accountability must begin now.