Medicaid Director Explains Why Millions Have not Been Spent

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The revelation by Congresswoman Aumua Amata Radewagen yesterday that millions of Medicaid dollars for American Samoa remain unused has come as a shock to many including medical personnel.

Especially at a time when the LBJ Hospital is desperately in need of money.

Appearing as a guest on the Samoa Sunrise Show yesterday, the congresswoman said that about $189 million of American Samoa’s share of $1 billion under the Affordable Care Act has not been spent.

She said the territory has a deadline to spend this money otherwise we will lose it.

Responding to KHJ News questions, Director of the American Samoa Medicaid Office Sandra king Young explained that there’s $150 million remaining of the Medicaid money from ACA.

American Samoa gets two pots of Medicaid money…the regular Medicaid funding under the Social Security Act brings in about $11 million, and the ACA Medicaid pot which has the unspent money,

King Young cited that the ACA pot cannot be spent unless the regular Mediaid money has all been used.

This has been explained several times by the CEO of LBJ Hospital Taufetee John Faumuina Jr.

The Medicaid Director explains that this ACA Medicaid money expires in 2019 unless the Republicans repeal all of ACA as they have been trying to do OR unless American Samoa’s Representative to Congress succeeds in extending the time for us to expend this money.

Congresswoman Aumua says she has requested an extension to the deadline.

A further explanation of the drawdown process for Medicaid funding is necessary in order to understand why there’s a pile of money for American Samoa’s health care has not been spent, yet LBJ is hurting for funds.

American Samoa has to first provide medical services that are allowable expenses under the Medicaid program.

King Young says so far, because LBJ has been our only Medicaid provider, it has been the only provider that could draw Medicaid funds for allowable Medicaid expenses.

She says, “Keep in mind that we have only so many people who get sick or need medical care…there is only so much that LBJ can do…so our expenditures of Medicaid will always be limited based on the amount of allowable medical services we can actually provide through LBJ.

Since 2011, LBJ has been able to draw no more than $5 million a year in additional ACA Medicaid money.

That means since 2011, the territory has only been able to draw about 20-25% of the ACA Medicaid money.

The Medicaid Director, the main reasons for not expending the ACA Medicaid money is we don’t have enough medical services like no off-island medical referral, we don’t have enough Medicaid providers and quite frankly, the ACA bill was written with no territorial input so it was not written based on our needs.”

She adds, “We have and will continue to amend our Medicaid State Plan to provide access to these services.

“Unless we provide more medical services, we will never be able to draw the remaining $150 million by the 2019. Getting approval from CMS to make the FQHC available and to enable my office to reinstate the off-island medical referral program through my office, will help us draw this money down.”

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