The North Carolina Court of Appeals has ruled that the state must expand Medicaid to cover illegal immigrants to allow for longer treatment for serious health problems. This ruling can expand the number of medical treatments that illegal immigrants in North Carolina are able to receive and may allow hospitals that already treat illegal immigrants to receive more Medicaid reimbursements.
The panel of appellate judges found that the stateís Department of Health and Human Services had misapplied Medicaid rules in the treatment of an undocumented worker from Mexico, Benito Luna. Luna was admitted to Moses Cone Hospital in Greensboro, North Carolina in December 1999, where doctors discovered that he had cancer of the spine. Two days after being admitted, doctors operated on Luna and gave him chemotherapy for the next month. State and county Medicaid officials paid the hospital for the surgery but not the chemotherapy.
Medicaid does not fully cover illegal immigrants, but federal and state regulations require that the program must cover treatment for emergency medical services given to the poor. State officials had denied the chemotherapy claim because they felt that the surgery had stabilized Lunaís condition. The court found that the state and a lower court had not considered that Lunaís health could have seriously deteriorated without the chemotherapy treatments.
The appellate decision can be found online at http://www.aoc.state.nc.us/www/public/coa/opinions/2004/020557-1.htm.
The El Paso Service Processing Center, the immigration detention facility in El Paso, Texas, is has taken on the role of a mini-hospital for detainees. Between 150 and 200 come to the center for medicine, exams, blood analysis, X-rays and dental work. The Joint Commission on Accreditation of Health Care Organizations, the National Commission on Correctional Health Care and the Commission on Accreditation for Corrections recently accredited the detention facility.
The detention facility houses about 700 immigrants and its medical center has a physician, a psychiatrist, nurses and a visiting dentist, most of whom are bilingual.
A provision of the Medicare bill provides $1 billion for hospitals that provide emergency medical care for undocumented immigrants. Much of this money will be allocated over a period of four years to hospitals in states that have the highest numbers of undocumented migrants. The Department of Health and Human Services still needs to determine how much money should be given to the individual hospitals that qualify.
By law, hospitals cannot turn away patients who need emergency medical care, nor can they ask about a patientís immigration status. Health care analysts estimate that hospitals pay $2 billion to treat undocumented immigrants who cannot pay their bills.
Representative Dana Rohrabacher (R-CA) introduced HR 2722 to Congress on January 21, which would limit health care to illegal immigrants. The bill proposes to hold employers who employ illegal immigrants responsible for their healthcare bills. The bill would also require hospitals that receive federal funding for treating illegal immigrants to ask their patients whether they are US citizens and enter information about non-citizens into a database. The database could then be accessed and used by the Department of Homeland Security.
According to Rohrabacherís office, since introduction of the bill, the Representative and his staff have received several death threats and abusive phone calls.
Federal officials will review the Commission on Graduates of Foreign Nursing Schools, a not-for-profit Philadelphia company that screens most foreign nurses seeking jobs in the US. The company has been in operation since 1996, and has no rival companies, nor any federal oversight. Media reports, particularly an extensive investigative piece on the Philadelphia Inquirer, have questioned CGFNSí poor customer service, particularly its slow processing times and errors made in processing applications.
According to a 2003 survey of 681 emergency department managers and administrators, the increase of ambulance diversions can be attributed the lack of specialty physicians for certain medical situations. This view is contrary to the popular belief that ambulance diversions are due to overcrowding in emergency rooms.
Of those hospital administrators surveyed, 18% said overcrowding caused them to divert ambulances to other hospitals. 75% of those surveyed said lack of specialty physicians caused them divert ambulances to those hospitals with specialty physician coverage. This is an increase from the 63% in 2001.
33% of surveyed hospitals said that they had lost specialist who were willing to be on call in the emergency room over the last year. 15% of the administrators surveyed said that, if given a choice, they would not go to their own hospitalís ER if they were seriously injured due to inadequate specialist coverage.