American Samoa's only hospital, the LBJ, is to resume sending people off island for medical care after a six gap because of a lack of money.
The paid for referrals had ended in 2008 because the hospital did not have the money.
Our correspondent Monica Miller says the hospital has finally got access to income from a tax increase set up two years ago, partly for that purpose.
"They have resumed sending patients off-island however the funding or subsidy for a patient is only to cover airfares. Before when the programme was running very smoothly the LBJ hospital was covering all of the transportation costs as well as the treatment costs."
Monica Miller in Pago Pago.