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Lolo says ASG Medicaid Office will work to reestablish medical referrals to Hawai’i

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King-Young: We can’t touch the $84 million if we don’t have the local match

Pago Pago, AMERICAN SAMOA — Gov. Lolo Matalasi Moliga is “optimistic” that the government will be able to re-establish the off-island medical referral program with Hawai’i healthcare providers, following two years of successful reimbursement and services provided through New Zealand medical facilities.  

And with the new $84 million approved for the Medicaid program for American Samoa by the federal government, the governor has directed the Medicaid Office and two other cabinet members to identify revenue sources for the territory’s matching funds.

In his 232-page State of the Territory Comprehensive Report last week to the Fono and the US Department of Interior, Lolo explained that the Off Island Medical Referral New Zealand (OMRNZ) program was established as a result of denial by Hawai’i providers in accepting referral patients from American Samoa.

He said previous administrations’ inability to pay medical bills of patients referred to and accepted by Hawai’i medical providers “severely damaged the territory’s credit worthiness” in Hawai’i, where medical care is also more expensive than New Zealand.

According to Lolo, it’s the policies of the US and American Samoa governments to expend U.S and American Samoa taxpayer dollars in the U.S; and the ASG Medicaid Office “will resume its efforts to re-establish a pathway for referrals to Hawai’i.”

“Armed with two years of successfully reimbursing [healthcare] providers in New Zealand and now with the increased block grant funding the outlook for re-establishing referrals to Hawai’i is optimistic,” Lolo said.

He noted the $84 million recently approved for American Samoa by the US Congress for fiscal years 2020 and 2021, and said ASG must prioritize providing the Medicaid agency the local match of $10-$30 million to help draw down these new federal funds.

In his 40-page written State of the Territory Address last Monday, Lolo explained that the OMRNZ program went into effect April 2017 and was launched in November of the same year.

Since then, he said, Medicaid has paid $7.9 million for the OMRNZ in medical care, transportation, and accommodations. “No other health insurance model is designed like American Samoa’s OMRNZ with comprehensive coverage from beginning to end of referrals.”

Since the start of the OMRNZ program, Lolo said Medicaid has referred 582 patients to New Zealand, with 71% or 429 patients referred in calendar year 2019 alone. Approximately 47% of total patients were referred between August-October 2019 (or 34% of total program beneficiaries) since the start of the OMRNZ program. Of the 582 patients referred to NZ, a total of 466 patients have already completed their appointments.

“Never before in the history of the territory have so many people, from all walks of life, been referred off-island within a period of two years with their medical bills, transportation, and accommodations fully paid for 100% by the Medicaid program,” Lolo said. “Hundreds of patients have received life-saving treatments that have not only saved their lives, many have improved their quality of life.”


ASG Medicaid Office director Sandra King-Young gave an update on the referral program during a Jan. 10th cabinet meeting, saying the program was suspended last October “because the funding that waived the local match for us was coming to an end and, of course, we spent 80% of the local match budget, and it was dwindling.”

She presented specific data on the number of patients sent on the referral program over the last two years; the numbers spiked between June and October 2019. “And that’s significant because that was when the Disaster Relief Act was passed by Congress which gave us the 100%” waive on local match.

She explained that this was also the time period that her staff worked 7 days a week  and into the night to make sure patients are taken care of, due to the fact that New Zealand is a day ahead of American Samoa, and local patients have to connect through Samoa, where flights depart during evening hours.

She then pointed to the $84 million passed by Congress for American Samoa for FYs 2020/ 2021. “This is historical. It’s never been done before by Congress,” King-Young said, and added that the “fight is now over for us” because the allocation is only for two years.

“We no longer have to worry about the federal funding. LBJ will probably receive $25 million of the $84 million. And the rest is up for the territory, to basically deliver all of the services we can do, including cancer treatment,” she explained. “The only problem is, we cannot touch that $84 million if we don’t have the local match, which we’ll need for right now — it is 36%.” (Samoa News estimates that’s about $30+ million in matching funds needed.)

According to the Medicaid Office director, there’s about $800,000 left in the local match budget for FY 2020. “So we’re hoping we can resolve that.”

King-Young said they are looking at resuming the referral program in the next few weeks, “once we finish paying off all our bills… which [there] is little left to pay.” At the time of the cabinet meeting, the program only had one child-patient in New Zealand. She said the exemption was made for the child, “who had a very complicated case” and it is hopeful that the child will return home soon.

ASG plans to issue a public announcement once the referral program is set to restart.

The governor directed King-Young, along with ASG Treasurer Uelinitone Tonumaipe’a and LBJ chief executive officer, Faumuina John Faumuina to meet and work on a way to secure matching funds.


King-Young issued a verbal reminder, that under the referral program, the person goes to LBJ for the program. For her office, “we do review of eligibility for residency. We don’t accept the case, we review that you are a legitimate resident of American Samoa,” she said. “Just because you’re a United States citizen, and live in American Samoa, does not make you eligible for Medicaid,” she explained. “You have to be a bonafide resident of American Samoa.”