The LBJ hospital in American Samoa is disputing public claims from patients who say they are just finding out now about the change in fees at the hospital.
The board chairman, Charles Warren says the fee change for non-residents went into effect on April 1st, and several media organisations provided extensive coverage prior to the increases.
He says the hospital board and management has done its best to inform the public.
There have been several complaints that the new non-resident fees are not posted at the hospital.
But Mr Warren says there are over 3,000 separate charge items and its impossible to place all the fees on a simple poster.