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Medicaid winds down off-Island referral and other services

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Source: American Samoa Medicaid Office

Pago Pago, AMERICAN SAMOA — Unless Congress acts before December 31, to pass federal legislation to provide additional Medicaid funding to American Samoa come January 2020, Medicaid will temporarily suspend certain services for patients (except reimbursements to LBJ Hospital).

Medicaid added new services nearly 3 years ago to help increase benefits coverage to eligible Medicaid beneficiaries with the availability of the 2011 Affordable Care Act (ACA) funds. Now that those funds are expiring, Medicaid must preserve its regular annual Medicaid block grant to continue coverage of services at the LBJ hospital for the remainder of the fiscal year.  

This week, Medicaid begins winding down services it added as a result of reform to the Medicaid program due to the availability the ACA that provided $197 million ($181 section 2005 funds and $16 mil Section 1323 funds) to the Medicaid program.

Usage of that funding was strictly limited to reimbursements only to LBJ Hospital which was unable to draw those funds due to limited services and limited local subsidies — it was only drawing an average of $4 million a year. The 8-year legislation providing the Section 2005 $181 million funding expired on September 30, 2019.

For the remainder of the year, Medicaid still has $16 million of Section 1323 ACA funds left to use before it expires Dec. 31, 2019. Starting January 1, 2020, Medicaid will have its regular annual block grant of $11 million to fund only the LBJ hospital.  

Sandra King Young, local Medicaid Director said, “Unfortunately, except for a temporary relief on the local match requirement we achieved over the last 4 months, there is nothing more our Medicaid office can do at this point except wait and see what Congress does before the end of the year.

“The Medicaid program does not end, only the new services administered directly through the Medicaid office will be put on hold until Congress passes new funding laws for the territories.

“Our priority is to use our regular annual block grant that is left to keep our only Hospital operational,” she concluded.