The chief executive of the financially troubled LBJ Hospital in American Samoa says they plan to increase fees to help the institution pay its way.
The hospital has long struggled to meet its bills, leading to drugs shortages and service cutbacks.
There are reports that 200 staff have had their hours cut and some services have been dropped, in a bid to reduce expenditure.
But CEO John Faumuina says the changes are not that severe and will have little effect on services.
"We are still continuing to operate. It is just the clinic hours, the outpatient clinic hours which we are reducing by eight hours a week."
Mr Faumuina's comments come as the Senate has summoned him and the Board to a public hearing tomorrow to explain the financial situation and continuing shortages at the hospital.
Mr Faumuina has indicated that the hospital is planning to raise hospital fees to try and meet its costs.
