Health care providers can now charge the U.S. government for emergency care provided to illegal immigrants.

The Centers for Medicare and Medicaid Services issued final guidance May 9 that sets up a system for reimbursement. Lawmakers set aside $1 billion over four years for the program, created by Medicare legislation passed in 2003.

For hospitals in border states like Arizona, the additional money can mean the difference between running a profitable business or an unprofitable one, said Don May, vice president of policy for the American Hospital Association.

“I don’t know if it will completely change their financial picture, but for those hospitals on the border, this is going to make a difference in ensuring they are there to treat the patients, not just the undocumented ones, but all the patients living in those communities,” Mr. May said.

Two-thirds of the money will be distributed to health care providers based on a state’s percentage of undocumented aliens. The remaining third will go to providers in the six states with the largest number of arrests of undocumented immigrants.

The states receiving the highest amounts in the current fiscal year are California, $70.8 million; Texas, $46 million; Arizona, $45 million; and New York, $12.25 million.

Payments to providers will be made on a quarterly basis and will be adjusted proportionately if the bills exceed the state’s allocation.

The funding “is a good start (but) it doesn’t completely cover all of the costs,” Jeanine L’Ecuyer, a spokeswoman for Governor Napolitano, said.

A report released May 9 by the Government Accountability Office showed Arizona got federal reimbursement for only 14 per cent of its $100 million in costs in 2002 and 2003 for incarcerating undocumented immigrants accused of crimes.

Ms. Napolitano has been sending invoices to the federal government for those reimbursements since February.

Napolitano Sent Bill To Feds

On March 24, Ms. Napolitano sent a bill for $195.6 million for the costs to Arizona’s prison system for the years 2003, 2004 and part of 2005.

Hospitals are required to provide emergency care to patients regardless of their ability to pay or their status as citizens. Mr. May said hospitals were concerned that the federal government could have discouraged illegal immigrants from getting emergency care if information gathered from the patient was then used to deport them, but those concerns have eased.

Mr. May said hospitals would ask patients three questions: whether they are eligible for Medicaid, whether the patient has received a borde-crossing card, and whether a patient is foreign-born.

Mark McClellan, administrator for the Centers for Medicare and Medicaid Services told reporters in a conference call that the information would not be used to deport immigrants, but in rare circumstances, the information could be used in criminal cases.

“We won’t use this information in any immigration proceedings,” Mr. McClellan stressed.

The federal agency assumed some patients would refuse to state their place of birth, so it will allow hospitals to allocate up to 10 per cent of their claims to such cases. —

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