BMH Administrator "moonlighting"

May 2, 2012

The Morning News — Leslie Mielke Louis Kraml, administrator of Bingham Memorial Hospital

BLACKFOOT — Louis Kraml, administrator of Bingham Memorial Hospital (BMH), is doing some moonlighting.
Kraml and Dan Cochran, an associate and friend of Kraml's for the past 22 years have formed a coding and billing company called International Consulting Services (ICS), LLC.
A contract was proposed between ICS and the Commonwealth Healthcare Corporation (CHC) in Saipan, Northern Mariana Islands, a U.S. territory. The islands are across the International Date Line, way east of Hawaii, and a little north and west of Guam.
"This started as a humanitarian effort," Kraml said. "Dr. John Whiting, [who works with BMH], is an international radiologist. He worked for a month in Guam.
"I dropped your name while [in Guam]," Kraml said Whiting told him.
Kraml’s contract with BMH does not prevent him from outside contracts such as the one in Saipan.
CHC is the only hospital in the Northern Mariana Islands. It serves about 55,000 people. The condition of the hospital worsened when the governor and the Legislature appropriated only $5 million for the newly created healthcare corporation. Its predecessor, the Department of Public Health, used to have an annual budget of $38 million.
Above and beyond the elimination of operating funds, the next historical challenge was the “broken” financial system.
Years of backlogged billings, massive undercharging of Medicaid for services, being unable to bill for supplies and services, lack of medical coding expertise and the dependency and entitlement culture of a government-funded organization were cited as the major deficiencies
Kraml's reputation for turning rural hospitals around played a role in the Saipan hospital's administration contacting him.
When Kraml started at BMH, “the hospital was broke,” said Bingham County Commissioner Cleone Jolley. “The hospital couldn’t make payroll.
“Now the hospital is making money; the hospital has improved and it offers excellent care.
“He’s done a lot for our hospital,” he said. “He’s done things that are best for business.
“Kraml has expertise to help a hospital,” said Jolley.
In Saipan, CHC had signed a contract with International Consulting Services on Feb. 28, 2012.
By April 17, the Commonwealth’s Attorney General had signed a cease and desist order.
Attorney General Edward Buckingham cited three reasons: The matter was not announced for bid; the Division of Procurement did not review this matter; the Office of the Attorney General did not review or approve this matter.
According to the constitution of the Northern Mariana Islands, the Attorney General’s office must approve contracts for public entities such as CHC.
Three days later, Gov. Benigno Fitial signed an executive order declaring a state of emergency at the Commonwealth Health Center. This state of emergency reinstated the contract with ICS for 45 days.
As of Tuesday, “we are still developing a contract [between CHC and ICS],” said Commonwealth Attorney General Edward Buckingham. “If there is no contract, the cease and desist order will go into effect. After 45 days, the [hospital’s] contract will go out for bid. 
"This will not drag on," Buckingham said.