Medicaid funding increases for FY 2022 — and so will accountability
Pago Pago, AMERICAN SAMOA — American Samoa will receive around $88 million in Medicaid funding for the fiscal year (FY) 2022. It’s an increase from FY 2020 and 2021 allotments, which were around $86 million.
In a letter to the local Medicaid Director, Sandra King Young, dated September 24, 2021, the Centers for Medicare & Medicaid Services (CMS) notified her that the federal allotments for each of the territories were based on the statutory language of the Social Security Act.
The new allotment or grant for American Samoa begins on Oct. 1, 2021.
The letter also pointed out that the calculation of the allotment “does not affect your territory’s Federal Medical Assistance Percentage (FMAP)”, which “beginning October 1, 2021, your territory’s FMAP will revert to 55 percent, absent further Congressional action.”
The FMAP — matching funds — is currently 83%, but American Samoa only applies 67% because of the type of eligibility it applies, Presumptive Eligibility (PI), according the King Young. However, she says due to the increased funding, Congress and CMS have indicated the need for increased accountability and reporting. Hence, the transition to Individual Eligibility (IE).
In an email review of the news of the FY 2022 allotment increase with the AS Medicaid Director, Samoa News was told the transition to IE is part of the assurances that American Samoa will be able to report accurately, “as part of giving us increased funding.” The only way to do that is to do IE, she said.
With transition to IE, Medicaid will only cover US nationals, US citizens, US permanent residents, foreign "pregnant" women, and foreign children under the age of 21 years. “
We are negotiating with CMS to see if we can cover AS permanent residents.
“All others won't be covered at LBJ or DOH,” King Young noted.
She said the problem has come to light due to the increase of our community’s foreign population. It used to be 13% of the total population, but is now around 60%.
King Young said she appeared for a Fono hearing, and the Fono committee — once they understood, fully supported moving to the IE.
One of the advantages of IE will be the FMAP — which they are still pushing for the 83% — and moving to individual enrollment (IP) will allow the beneficiaries to use 83%, she said.
“IE will best serve our bona fide beneficiaries including coverage for cancer and other services we don't currently cover,” King Young said.