Medicaid Director Sandra King-Young appeared before the Senate Health Committee Thursday to discuss the resumption of Medicaid referral services, including the off island medical referral program at the start of the new fiscal year October 1st.
She assured senators that all of the $6 million that was approved in the Fiscal Year 2025 budget for the local match for Medicaid will be used for patient services.
The Medicaid program operates on a reimbursement basis where local funds are used to pay for patients services then Medicaid reimburses. The match rate is 68% federal and 32% local match. The Medicaid budget for administration for the new fiscal year is $1.2 million of which $800,000 is locally funded.
Responding to questions from Senator Togiola Tulafono, the Medicaid director reported that there are still some outstanding bills for referrals to New Zealand and the hotel bill for patients at the Pagoda Hotel in Honolulu which have not been paid. She was expecting the Centers for Medicare and Medicaid Services to give a waiver on the local match to settle these debts. But in the event the waiver is not received, she estimated that about $1 million of the FY2025 funding would go towards settling these debts.
The Medicaid Director explained that with off island medical referrals, not all patients that are recommended for a referral by the LBJ Hospital will be sent off island. She said an important requirement is that a hospital in Hawaii or New Zealand must first approve and accept the patient being referred. She said in instances where a patient is not accepted by an off island hospital, telemedicine is used whereby off island doctors will consult with local doctors for the treatment of a patient.
Senator Togiola reacted angrily to a statement by the Medicaid Director when he was questioning her about hospitals in Hawaii that the Medicaid Office has a contract with to accept local patients.
The only two providers in Hawaii are Adventists Health Castle and Eye Sight Hawaii.
Togiola was asking if there were any agreements with Queens, Kaiser and Straub. King Young responded that Queens and Straub have not forgotten the millions of dollars owed by LBJ Hospital for off-island referrals in the past. She said American Samoa’s credit was damaged as a result.
Togiola followed up if she had raised the matter with the Governor so he could address it from an executive level.
The Medicaid Director then reported that the Governor was involved in discussions with Queens Hospital and they made progress this year. She said Queens Legal Department is reviewing a proposed agreement.
Togiola asked her why she didn’t explain that in the first place, that if it wasn’t for his follow up question she wouldn’t have provided this information.
King-Young apologized and said she had always been advised to just answer the senators questions when asked. Togiola demanded to know who gave such advice.
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