Pago Pago, AMERICAN SAMOA — American Samoa’s Medicare and Medicaid Services has announced that it has been awarded 21% of the $20Mil made available by the Federal government under the Consolidated Appropriations Act of 2023. It is to be used to plan, develop and adopt two systems — an Eligibility and Enrollment (E&E) system and a Medicaid Management and Information System (MMIS) — to improve responses to inquiries, automate Medicaid systems operations including claims processing, streamline information retrieval, and manage reporting for planning and control.

Samoa News response:

ASMSA Finance Division Director, Epifania Solofa Esela when asked by Samoa News said “the award depends on the population and the amount of eligible residents,” as well as the data ASMSA provides.

She noted that usually Guam gets a higher amount due to its population.

The two other territories that make up the four that are mandated to submit a Four-Year Strategic Plan and two separate Planning Advanced Planning Documents (PAPD) to CMS to get access to the funds are CNMI and US Virgin Islands.

The local Medicaid Director Tofoitaufa Sandra King Young has indicated that the four territories will collaborate and are looking to access what they call “Leverage and Reuse” from other states and territories who have existing systems in place — “but we already know we cannot afford even the local match required.”

So, “It all depends on the feasibility assessment done by all our territories and how we decide to procure our E&E and MMIS systems,”

Ms Esela pointed out that “Medicaid is slowly transitioning into doing individual enrollment.”

She said, “I’m grateful for the technical assistance provided by CMS on this project.

“We are fortunate for this design and development award at 100% FMAP” — that it is “very good for American Samoa, because these systems are very expensive.”

Ms Esela added, “We’ve been trying to get one but it’s in the millions of dollars —  It can go up to $20- $30 million for a system.”

The limitation is in the local match she said, — “which our government doesn’t have.”

“For the last year, we spent around $58 million, close to $60 million,” yet “we are not registered and we are using data from the DOC and Immigration.”

She pointed out that “Medicaid relies on data to drive policies within our office and our program.

“It is becoming more critical to adopt automation of operations to keep up with the volume of data and information that we must manage for patient care coordination.

“We will eventually require patients to register and manage their referrals online.

“This is a process that improves how we do our work and also protects the rights to equal access for patients and program integrity for Medicaid.”