Medicaid Benefits: Online Database

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Acute Care Services

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Benefits by State: American Samoa (October 2004) Notes

Acute Care Services

Is the Benefit Covered?	Copayment Requirement	Prior Approval Requirement	Coverage Limitations	Reimbursement Methodology	Populations Covered

Institutional and Clinic Services
Clinic Services, by an organized facility or clinic not part of a hospital: Freestanding Ambulatory Surgery Center
No
Clinic Services, by an organized facility or clinic not part of a hospital: Public Health and Mental Health Clinics
Yes					See territory-specific FN
Federally Qualified Health Center Services
No
Inpatient Hospital Services, other than in an Institution for Mental Diseases
Yes					See territory-specific FN
Outpatient Hospital Services
Yes					See territory-specific FN
Rehabilitation Services: Mental Health and Substance Abuse
Yes					See territory-specific FN
Rural Health Clinic Services
No
Practitioner Services
Certified Registered Nurse Anesthetist Services
No
Chiropractor Services
No
Dental Services
Yes					See territory-specific FN
Medical and Remedial Care - Other Practitioners
See service-specific FN.
Medical/Surgical Services of a Dentist
Yes					See territory-specific FN
Nurse Midwife Services
Yes					See territory-specific FN
Nurse Practitioner Services
Yes					See territory-specific FN
Optometrist Services
Yes					See territory-specific FN
Physician Services
Yes					See territory-specific FN
Podiatrist Services
No
Psychologist Services
No
Prescription Drugs
Prescription Drugs
Yes				Prospective payment/Rx based on prior year cost	See territory-specific FN
Physical Therapy and Other Services
Occupational Therapy Services
No
Physical Therapy Services
Yes					See territory-specific FN
Services for Speech, Hearing and Language Disorders
Yes					See territory-specific FN
Products and Devices
Dentures
Yes					See territory-specific FN
Eyeglasses
Yes					See territory-specific FN
Hearing Aids
Yes					See territory-specific FN
Medical Equipment and Supplies
Yes					See territory-specific FN
Prosthetic and Orthotic Devices
Yes					See territory-specific FN
Transportation Services
Ambulance Services
Yes					See territory-specific FN
Non-Emergency Medical Transportation Services
Yes					See territory-specific FN
Other Services
Diagnostic, Screening and Preventive Services
Yes					See territory-specific FN
Early and Periodic Screening, Diagnosis and Treatment
See service-specific FN.
Extended Services for Pregnant Women
See service-specific FN.
Family Planning Services
See service-specific FN.
Laboratory and X-Ray Services, outside Hospital or Clinic
Yes					See territory-specific FN
Targeted Case Management
No

Long-Term Care Services


Community Based Care
Home and Community Based Services Waiver
No
Home Health Services, includes nursing services, home health aides, and medical supplies/equipment
Yes	Post-hospital care only, includes therapies	See territory-specific FN
Hospice Care
No
Personal Care Services
No
Private Duty Nursing Services
Yes	Limited to post-hospital care only	See territory-specific FN
Program of All-Inclusive Care for the Elderly
No
Institutional Care
Inpatient Hospital, Nursing Facility and Intermediate Care Facility Services In Institutions for Mental Diseases, age 65 and older
No
Inpatient Psychiatric Services, under age 21
Yes		See territory-specific FN
Intermediate Care Facility Services for the Mentally Retarded
No
Nursing Facility Services, other than in an Institution for Mental Diseases
Yes	Post hospital extended care only	See territory-specific FN
Religious Non-Medical Health Care Institution and Practitioner Services
No

Notes: This territory does not determine Medicaid eligibility on a case-specific basis. Instead, a “presumed eligibility” determination is made based on the percentage of the population (not counting illegal aliens) living below the federal poverty level. The calculation is made annually and is currently 87.7 percent. That percentage is applied to the computable costs of providing services, and the territory receives 50 percent of that amount as federal Medicaid financial participation up to a specified ceiling established in law. The Deficit Reduction Act of 2005 provided additional funds to the territory, thus increasing its payment ceiling for fiscal years 2006 and 2007. The ceilings for 2008 and subsequent years will be calculated by applying an adjustor, the medical care component of the Consumer Price Index, to the 2007 payment ceiling. The LBJ Tropical Medical Center is the primary provider of medical services in American Samoa. The territory does not provide the services of either chiropractors or occupational therapists because there are none available.