The Governor of the Northern Marianas Ralph Torres has lost confidence in the head of the Commonwealth Healthcare Corporation Esther Muña.
Mr Torres reportedly asked the newly formed corporation board last week to remove Ms Muña.
She said she had not been personally asked by Mr Torres or the board to step down from her position as chief executive and that she would not resign if she was asked.
The board chair Lauri Ogumoro said only that the board was working with the Office of the Governor.
Mr Torres earlier expressed dissatisfaction with Ms Muña's decision to prioritize US$200,000 for the renovation of the hospital's new outpatient pharmacy over the purchase of new equipment for its existing inpatient pharmacy.
The outpatient pharmacy was opened a week ago replacing a private facility.