LBJ announces intention to dramatically hike its fees


After exhausting its reserves in FY 2011 due to among other reasons, ASG's failure to provide more than $2 million in required subsidies in FY 2011, and the DOI only providing 50% of its subsidy in November, the LBJ Medical Center on Friday announced its intention to hike facility fees, which will go into effect Christmas Eve.

In a statement late Friday afternoon, the LBJ Medical Center said the last facility fee hike was in 2006 and the proposal will "significantly raise facility fees for self-pay patients" at the hospital, which includes both residents and non-residents.

(Samoa News has inserted the actual cost for services, as per the statement from LBJ, using brackets to indicate.)

LBJ chief executive officer Mike Gerstenberger told Samoa News yesterday that the fee for most outpatient services is currently $10 per visit and the current inpatient facility fee is $50 per day.

Under the proposed fee hike, outpatient services will be $50 per visit for Medical, ENT, Dental , Surgical, OB/GYN, Pediatric, Family Planning, Ophthalmology, and Family Medical clinics. The new fee for the Dialysis unit will be $250 per visit [$345].

For inpatient service, the new fee is $100 per day for Medical, Surgical, OB/GYN, Nursery and Nursery Intensive Care and Mental Health [$1070] clinics. For the regular Intensive Care Unit it will be $200 [$5,531]per day .

LBJ is hiking fees for other services - such as surgery ($200 per case [$1,141]) Labor & delivery ($200 per birth [$793]), Prescription ($40 per medication [$43]), Radiology ($50 per X-Ray [$88]) and these new fees are for both residents and non-residents alike.

"This adjustment is critically needed now as a result of uncertainty over government reimbursement for healthcare," according to the LBJ statement, adding that the Fono approved in FY 2011 about $4.16 million in ASG subsidies but LBJ received only $1.72 million or 37% of the appropriated amount.

As reported by Samoa News last month, LBJ said in its fourth quarter performance report for FY 2011, the Medical Center lost $2.89 million in subsidy funding and failed to qualify for an additional $2.89 million Medicaid dollars.

"The financial reserves for the Medical Center were exhausted to maintain hospital operations during FY 2011," the report says.

In the statement LBJ said funding from ASG is critical to the hospital because Medicaid, the principle source of hospital revenues, requires local matching funds.

"So, if LBJ does not receive its appropriation from ASG, it also forfeits an equal amount of Medicaid money that had been set aside for American Samoa," it says.

"Fiscal uncertainty continues in the current fiscal year," LBJ said, pointing out that in October, the hospital received only $100,000 of the $354,000 appropriated from ASG. Then last month, LBJ received a partial payment of $300,000 and last week received a supplemental payment to bring ASG current on subsidy payments for FY 2012.

"However, because the U.S. Congress has not passed a budget for the current year, the subsidy to LBJ from the Department of the Interior (DOI) was reduced by 50% for the month of November," said LBJ. "DOI is unable to advise us what funds, if any, will be available in December or for subsequent months."

"The expenses for the Hospital are regular and predictable. We cannot guarantee the availability of patient services without a regular and predictable revenue stream," said LBJ.

LBJ will work with Gov. Togiola Tulafono and the Fono to "identify sustainable sources of income to assure that LBJ will be here when you need us," the statement said.

"However it is clear from government at all levels that a component of that sustainability needs to be a greater personal responsibility for patients to fund their own medical care," it says

"We appreciate that the new rates and policies represent a significant increase and will create a burden for some. Please remember that in a true medical emergency or if a woman is in labor, that individual will always be treated and stabilized before there is any discussion about finances," according to the LBJ news release.

For patients with limited resources, LBJ will continue to offer its sliding scale payment program. Based on household income and expenses, this program will provide forgiveness of 1% to 100% of the hospital fees.

For those non-emergency patients who can pay for their care, LBJ says it will ask for payment of the facility fee, in full, prior to providing service.

"The Hospital will no longer enter into promissory notes for non-emergency care. Those patients who have outstanding balances for services previously received will be asked to pay at least 10% of the outstanding balance and 100% of the facility fees for service they seek before the care is rendered.

Members of the community wanting to comment on the fee hike may send comments to LBJ Tropical Medical Center, Post Office Box LBJ, Pago Pago, AS 96799 or via email at notice@lbj.as.

There will also be a public hearing in the LBJ Chapel on Monday, Dec. 19 from 3:00pm to 7:00pm regarding the new fees.

On his weekend radio program, Gov. Togiola Tulafono said he announced to directors in Friday's cabinet meeting that he had been informed by the hospital board of directors about the upcoming LBJ rate hike. He said it is needed by the hospital due to financial constraints for various reasons, including the delay in federal funding as well as ASG's inability to provide the rest of the subsidies in the last fiscal year, as the government was also facing similar financial constraints.

Togiola said this is not going to be an easy issue for the public and it will not be easily accepted by the community as American Samoa heads into the holiday season. He said the fee hike is unavoidable, adding that the government itself is faced with serious financial issues and unable to pay its debts such as utility fees.

He said there are administration revenue measures pending in the Fono and hopefully the Fono will act on these bills next year.

Togiola pointed out that the Executive Branch was forced to reduce working hours earlier this year due to the financial constraints, but revenue collections are slowly increasing, making it possible for ASG to pay some of its debts.( It should be noted that these reduced working hours returned to regular hours after about 3 months.)


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