Pago Pago, AMERICAN SAMOA — The American Samoa Medicaid State Agency (ASMSA) notified Gov. Lemanu P.S. Mauga and Lt. Gov. Talauega E.V. Ale in a memorandum dated January 16, 2024 of the depletion of local match at the end of the 2nd quarter of FY 2024 on March 31, 2024. At the time the Medicaid office requested additional funding for a supplemental appropriation to continue the Medicaid programs until the end of FY 2024. A month later, ASMSA informed the top ASG leaders that all Medicaid services would be suspended by March 1, 2024, a month ahead of their previously stated suspension date of April 1, 2024.

Samoa News was able to obtain a copy of the two memos notifying the leadership of the issue.

In the first memo, dated Jan. 16, ASMSA Director Sandra King Young informs the top government leadership of the unfortunate news that they are “approaching that threshold where we will run out of of Medicaid local match funds by the middle of the 2nd quarter of FY 2024 (February).

“To bridge the funding gap,” she states “and to continue Medicaid programs until the end of the fiscal year (September 30, 2024), I respectfully submit this request for an additional $6 million for a supplemental appropriation.

“The increase is an inherent consequence of expansion of Medicaid services and the return to normal with fully open borders post COVID.

“We are experiencing a steady and increased use of Medicaid benefits especially in the off-island medical referral program.”

Without receipt of the supplemental, King Young says that she will have to “protect the credit of the Medicaid agency and Medicaid program, by temporarily suspending Medicaid service,” as has been the case with past policy.

According to the ASMSA director, all their vendors will be notified of the suspension of all Medicaid services by April 1, 2024, “until such a time Medicaid receives a supplemental appropriation.”

She points out that per government policy the agency cannot spend beyond their appropriations, “which is $4 million for FY 2024.” ASMSA has already drawn down $3 million of that amount and a balance of $1 million remains in balance for the remainder of the fiscal year. “We estimate the need to draw this remaining balance by the end of January and it will (be) used with in a month based on our current spending.”

In the memo, King Young discusses some options that the agency can adopt to help manage their diminishing local budget, which includes scaling back on the number of off-island referrals and local services. She adds that, “we can suspend coverage of air transportation, accommodations and non-medical escorts; and if this fails, we should suspend all services.”

In the second memo, dated Feb. 16, 2024, King Young notified the top ASG leaders that due to the Medicaid subsidy funds (local matching funds) being “significantly decreased to a remaining balance of $200K for the 1st & 2nd quarter of FY2024, and $1 million remaining for Budget and Treasury department to load,” they were going to suspend all Medicaid services from March 1, 2024.

The ASMSA director pointed out that the funding “is insufficient to sustain services” until the end FY 2024. She explained that, “given the existing number of patients in New Zealand and Hawaii, along with patients awaiting travel, it is impossible to cover the costs associated with medical services, lodging and transportation…

“At the moment there are 10 patients in Hawaii 35 patients in New Zealand, and 57 patients awaiting travel.”

King Young stated that all Medicaid services are being suspended, “including the Off Island Referral Program, Vision Program DMEPOS, except for payments to the LBJ Hospital, Department of Health- FQHC, and Hope House, as they can provide their local match.”

“We will notify all our vendors that the delivery of Medicaid services will be suspended starting from March 1st, 2024, until Medicaid obtains a supplemental allocation of funds.”

Samoa News obtained a copy of the vendor notification letter, dated Feb. 29, 2024, which basically explains the reason for the suspension of all Medicaid services, and when it will resume — contingent on obtaining supplemental funding. There will not be any new referral requests until the funding issue is resolved, the vendors are told.

King Young does point out that ASMSA “will continue to cover those patients who are in progress of receiving services and who have already started their referral process with Medicaid.”