11.0311 Qualifications.

Cite as [A.S.A.C. § 11.0311]

To qualify for off-island medical referral, the patient must come within one of the categories set forth in 13.0601

(a) ASCA. These categories include:

(1) American Samoans, as defined in 41.0202(1)(c) ASCA, and their spouses and dependent children who are residing in American Samoa at the time medical services are needed.

(2) Contract employees and independent contractors of the American Samoa Government and their spouses and dependent children as provided by their contracts.

(3) Civil service employees of the United States Government, and, their spouses and dependent children; provided, that the American Samoa Government will pay only for round-trip transportation and not the medical expenses of such persons, unless they are qualified under other provisions of this section.

(4) NonAmerican Samoans who are lawfully residing in American Samoa at the time medical services are needed and have been lawfully residing in the territory continuously, except for vacations or visits for periods not to exceed 6 consecutive months, for 10 years.

(5) U .S. citizens, their spouses and dependents, whose hospital and medical services charges are waived under 11.0302 ASAC, shall be entitled to off-island medical care to the same extent furnished to American Samoans by the government; provided, that the citizen, spouse or dependent will be required to use and apply entitlement to hospital, medical and dental care benefits which he or she may have as a veteran of the armed forces or as a participant under any other program or insurance plan.

(b) In all cases of off-island medical referral, the American Samoa Government will be responsible for payment of hospital and medical services in excess of the cost of those services covered by insurance or payable under health care programs of the United States Government applicable to American Samoa. For purposes of this subsection, "insurance" means health, accident, motor vehicle liability, workers' compensation and other insurance coverage of hospital and medical charges and coverage of such charges authorized or permitted by law in place of insurance.

History: Rule 7-80, eff 24 Jun 80, § 2; and Rule 6-82, eff I Nov 82, § 1; and Rule 1-84, eff 16 Feb 84, § 4;and Rule 1-86, eff 10 Jun 86, § 1.