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New Zealand approved for off-island referrals funded by Medicaid

Officials from the Medicaid State Agency, led by Lt. Governor Lemanu Peleti Mauga, recently returned from a trip to New Zealand, to assess the health care system and confirm processes for patient referral coordination to the Land of the Long White Cloud.

Director of the American Samoa Medicaid Office, Tofoitaufa Sandra King Young told Samoa News that the health care system in New Zealand "ranks as one of the top health care systems in the world and is more affordable than the United States."

Therefore, "We will be able to stretch more of our limited dollars to send more of our patients for high quality health care services to New Zealand than we could to the US," she continued.

According to Tofoitaufa, "The Medicaid State Agency worked very hard on this change to the Medicaid State Plan and retained an actuary to conduct and in depth financial analysis - comparing costs to Hawaii and the US mainland."

She said New Zealand provides high quality patient care and is much more affordable.

"The Medicaid State Agency's responsibility is to develop referral procedures pursuant to Medicaid regulations and approved by CMS (Centers for Medicare & Medicaid Services). Referral procedures must ensure patient access, fairness, transparency, and compliance under the Medicaid State Plan for all Medicaid eligible patients."

The Medicaid agency will publicize procedures in the next few weeks.

Tofoitaufa shared that the purpose of the trip was to "assess patient accommodations and meet the medical providers that the Medicaid program will use for Off Island Medical Referral (OIMR) services."

She reported that the trip was "very successful".

"We came away very confident knowing that our patients will have access to a high performing health care system that is very patient-centered. Our patients will have access to some of the best private providers in New Zealand and state-of-the-art facilities."

As for a time frame of when off island referrals can start traveling to New Zealand, Tofoitaufa responded, "Medicaid is still finalizing the operational details of the referral services and will announce them as soon as we also receive approval of those procedures from CMS."  

On the issue of which hospitals will accept referrals from American Samoa the Medicaid office director said, "Whichever hospital in New Zealand the patient needs to go to for services — but primarily Mercy Ascot Hospital in Auckland, and Braemer Hospital, a couple of New Zealand's best private hospitals."

On the question of what is covered by Medicaid and what has to be forked out by the patient, Tofoitaufa answered, "We are still finalizing that, but Medicaid will at a minimum cover air transport and all medical costs."

The Medicaid program is a reimbursement program and it has a fundamental requirement mandated by federal law.