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LBJ fee hikes scheduled to begin Monday, May 21

LBJ Medical Center is proposing new facility fee increases scheduled to go into effect May 21, after the hospital filed official notification on Monday with the government, in accordance with the American Samoa Administrative Procedures Act.

Hospital chief executive officer Mike Gerstenberger said some fees will increase, some remain unchanged, some will be capped, and a few will be lowered. 

“We are obviously interested in enhancing revenue but also want to encourage healthy behaviors, such as filling prescriptions, getting maintenance laboratory studies and making appropriate use of the Emergency Department,” he said yesterday.

In general — for residents—most Outpatient Clinic visit fee will increase from $10 to $20; while Emergency Department visit fees will increase from $10 (Daytime) and $20 (Nighttime) to $30 anytime — which means it’s always cheaper to visit a clinic than the Emergency Department, said Gerstenberger.

Outpatient Clinic visits include Dental, ENT, Family Medicine, Family Planning, Mental Health, OB/GYN, Ophthalmology and surgery.

Most ambulance service — provided by the Emergency Medical Service (EMS) — will be $20 per trip, plus mileage, while Advanced Life Support (which is very rare) will be $40 per trip, plus mileage. According to the LBJ fee schedule, ambulance mielage is $3 per transport mile.

For Pediatric, Nursery, Nursery Intensive Care and Mental Health units, daily fees will increase, “reflecting the higher staffing levels required in those areas”, said Gerstenberger.

Medical, Surgical, OB/GYN and Mental Health units are $50 per day while it’s $30 per day for Pediatric, Nursery or Neonatal ICU Nursing units and $100 per day for Intensive Care Unit, according to the fee schedule.

Other fees for residents:

•            Lab fees have increased from $10 per test to $15 per test, for a panel of automated tests;

•            Fees for standard X-rays will increase from $10 (per series) to $15 per series;

•            Fees for dental appliances, such as dentures, crowns and bridges will increase about 30% — reflecting the higher price of gold and other materials used in the appliance, said Gerstenberger.

•            Prescription Fees are unchanged;

•            Most Adult Inpatient Daily Fees are unchanged;

•            Ultrasound, CT Scan and Fluoroscopy Study Fees have decreased;

•            Mammography Fees are unchanged.

“True Medical Emergencies and Women in Labor will always be treated and stabilized before there is any discussion of finances,” said Gerstenberger. “Our Sliding Scale Discount Program remains available for those patients with limited resources. Once eligibility is determined, the discount is good for a period of one year and may be renewed annually.”


The proposed rate hikes are a little different and much higher in certain areas, according to the fee schedule. For example, outpatient clinic visits are $20 which is “due at time of service” and $85 is the “balance due later”. For an Emergency Department visit, it’s $30 “due at time of service” and $100 is the “balance due later”.

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”.


Besides a public notice posted at certain areas of the hospital facility, LBJ is also publishing in the Samoa News tomorrow through Saturday an advertisement outling specific fee structures for both residents and non-residents.

According to the public notice on the new proposed fee hikes, the last time facility fees were increased at the only hospital in the territory was in 2006. “As you know the costs of utilities, water, fuel, shipping and most of the items you purchase have increased during that time period,” states LBJ.

Additionally, the rate of “medical inflation” — the cost of medication and medical supplies — has increased at a rate much greater than the cost of other items.

“Simply put, in 2012, the Medical Center must pay more for all of the things it must purchase to deliver medical care to you,” it says, adding that no public hearings have been scheduled to discuss these changes, but the public may wish to request a public hearing directly to LBJ.


Gov. Togiola Tulafono used his weekend radio program, last Saturday, to announce that the LBJ Medical Center will be implementing new facility fees and offered in advance a public apology to the community in the event the move by LBJ happened soon.

He said the hospital needs to raise additional revenues because of the outcome of the Senate’s decision. (The Senate has rejected the administration bills for an $8 million loan from the ASG Retirement Fund and a separate $10 million appropriation funded with a hike in excise tax and business licenses fees.)

Togiola said there will be a hike in hospital facility fees because the government was not able to achieve its goal of a new financial aid package for the hospital. He said the Executive Branch will continue to knock on the doors of the Fono in the hope of getting approval for new money for LBJ.