OMRP outlines steps to avoid Fraud, Waste, and Abuse
Medicaid Director Sandra King Young and staff presented at the LBJ Hospital CME this week on the American Samoa Off-island Medicaid Referral Program (OMRP).
The program is unique as it generally covers 100% of the medical costs, air and ground transportation, and accommodations for a specific duration.
In a statement, the Medicaid Office noted there is a stringent process for the Off-island Medicaid Referral Program.
It starts at LBJ Hospital and must initiate the medical referral.
The Medicaid referral process has four critical steps designed to protect against Fraud, Waste, and Abuse (FWA).
A fundamental program principle is that only one entity can make a referral, having been approved through all four steps of the referral process.
Since Medicaid reinstated the off-island medical referrals in FY2018, nearly 2000 American Samoa residents have been referred under the OMRP.
Medicaid also covers MedEvacs and patient referrals from Manu'a to LBJ Hospital.