Pago Pago, AMERICAN SAMOA — While the American Samoa Medicaid State Agency (ASMSA) has suspended all its services, as of Mar. 1, 2024, due to depletion of the local match, it now looks like the government is not even paying Medicaid bills that should be paid with local match funds that have already been obligated or encumbered on the government financial/ accounting system.

A reliable source told Samoa News that ASMSA was recently denied two requests it made to medivac out of New Zealand for emergency care off-island due to outstanding amounts owed. The bill is supposed to be paid with local share Medicaid funds.

 ASG has been told that ASG is paying Medicaid bills that are paid with federal funds, but not the ones that should be paid with the local share of Medicaid funds, i.e. medivac.

 One of the medivac requests was for a senior citizen, while the other was for a pediatric patient, according to the reliable source.

Samoa News has reached out to the Governor’s Office and ASMSA for comments.

Issues with the Medicaid local share was reported by Samoa News at the beginning of this month when it obtained copies of memorandums the ASMSA director Sandra King Young sent to Gov. Lemanu P.S. Mauga and Lt. Gov. Talauega E.V. Ale.

The first, dated January 16, 2024, notified them of the depletion of local match by the end of the 2nd quarter of FY 2024 on March 31, 2024.

At that time the Medicaid office requested additional funding for a supplemental appropriation to continue the Medicaid programs until the end of FY 2024. An additional $6 million was requested by ASMSA director.

A month later, in a second memo, dated Feb. 16, 2024, ASMSA informed the top ASG leaders that all Medicaid services would be suspended by March 1, 2024 instead— a month ahead of their previously stated suspension date of April 1, 2024.

King Young notified the top ASG leaders that due to the Medicaid subsidy funds (local matching funds) being “significantly decreased to a remaining balance of $200K for the 1st & 2nd quarter of FY2024, and $1 million remaining for Budget and Treasury department to load,” they were going to suspend all Medicaid services from March 1, 2024.

She pointed out that per government policy, the agency cannot spend beyond their appropriations, “which is $4 million for FY 2024.”

ASMSA has already drawn down $3 million of that amount and a balance of $1 million remains in balance for the remainder of the fiscal year. “We estimate the need to draw this remaining balance by the end of January and it will (be) used with in a month based on our current spending.”

Samoa News understands it’s this $1 million, obligated or encumbered in the ASG system that has not been paid out to cover the off-island bills.

In her memo, the ASMSA director also stated that ASMSA “will continue to cover those patients who are in progress of receiving services and who have already started their referral process with Medicaid.”