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LBJ: By ‘virtue of the law’ only residents subsidized by gov’t

LBJ Medical Center has defended the proposed fee hike for non-residents, which goes into effect May 21 along with a slight fee hike for individuals considered residents.

Responding to Samoa News questions submitted early this week, LBJ chief executive officer Mike Gerstenberger said yesterday that the “non-resident fee structure has been in place according to the statute, since 1962” and it appears to have been amended in 1968, 1972 and 1998. 

“So the two-tiered system is nothing new. I am sure the specific fees have changed over the years,” said Gerstenberger, who confirmed that a non-resident pays the sum of the initial payment and the balance later.

According to the new fee schedule, outpatient clinic visits for non-residents are $20 which is “due at time of service” and $85 is the “balance due later”; while visits to the Medical, Surgical, OB/GYN and Mental Health units are $50 “due at time of service” and $695 is the “balance due later”.

Based on the fee schedule, the highest fee for non-residents is the Intensive Care Unit, which totals $895 per day — with $100 paid at time of service and the balance due later.

“By virtue of the law, the ASG has established that it will only subsidize American Samoan residents,” Gerstenberger explained. “It does so via the ASG subsidy to the Hospital and the Medicaid match.”

He also points out that the determination of who is eligible is in the statute ASCA 13.0602 — titled “Persons entitled to free medical attention-Limitations-Extent” and states that Medical Attention shall be provided free of charge by the government to the following persons:

•            All American Samoans, including those who are not American Samoans but are married to an American Samoan, and their children if they are residing in American Samoa at the time the time medical attention is rendered;

•            non-American Samoans who have legally resided in American Samoa for at least 10 years prior to the time medical attention is rendered;

•            civil service employees of the United States of America assigned to duty in American Samoa and persons who are exempt from payment of medical charges by virtue of contracts with the government and spouses and children of such persons.

The statute also states that free medical attention is limited to persons presenting themselves at Department of Health clinics, health centers, or Medical Center facilities and does not include house visits or consultation at other places unless made at the convenience of the physician, but nothing contained in this section may be construed as limiting the right of the Department of Health, or the Medical Center to make a reasonable charge for the use of their respective facilities.

Additionally, dental attention shall be rendered in the same manner and under the same conditions as medical attention, according to the statute.

“In addition,” said Gerstenberger, “there is some Administrative Code language that states that the ‘resident’ must be able to document that they have been living in American Samoa for at least six months to be eligible for ‘free medical attention’. That, too, is unaffected by our current facility fee increase.”

Meanwhile, Samoa News has received word that some residents have contacted their lawmakers to complain about the “drastic fee increase" for non-residents. One local resident on Wednesday wrote to Rep. Larry Sanitoa, saying “I must strongly express my concern and disappointment at the latest LBJ proposed fee increases.”

“I am most concerned with the discrimination against ‘non residents’, says the email copy obtained Wednesday afternoon by Samoa News. “It is immoral and probably unconstitutional to financially disadvantage one section of the population like this.”

A female resident of Tualauta said the “non resident fee... is way too expensive, not affordable, and will serve no purpose as these individuals will probably wait until an illness gets worse before going to the hospital.”