The American Samoa LBJ hospital will this week ask the legislature, the fono, for funds to send patients overseas for diagnosis or treatment.
Last year's funds have been used up, and there jas been no allocation for overseas referrals in this budget year, which starts next month.
This affects 45 patients suffering from cancer, kidney or cardiac problems who need treatment off-shore.
The chief executive officer of the LBJ hospital, Patricia Tindall, says there's still hope for government funding.
"We did submit a supplemental appropriation bill for consideration through the administrative branch and then it'd be considered by the legislature, the fono, for funding. We're hopeful that there'll be funding to fund our request."
Patricia Tindall says if the budget for referral patients remains at zero, then they will have to pay for their overseas treatment themselves or get a charity to sponsor them.