GOVERNMENT & MEDICINE

Hassles stymie physician pay for care of illegal immigrants

Without hospitals' help, doctors might not have the resources to tap into the funding.

By Joel B. Finkelstein, AMNews staff. June 13, 2005.

Washington -- The federal government has established a new pot of money to pay for uncompensated emergency care for illegal immigrants, but many physicians could find that bureaucratic hurdles put that money just out of reach.

Federal officials recently published final rules on the distribution of $1 billion over the next four years to compensate hospitals, doctors and ambulance services to provide emergency care to illegal residents.

But accessing that money requires hospitals to ask patients for various forms or documents that directly or indirectly indicate their immigration status. Many hospitals currently don't collect and are unlikely to start gathering this information.

Without the hospitals' cooperation, emergency department physicians might have to forgo the new government money, said Gordon Wheeler, a spokesman for the American College of Emergency Physicians.

Program participation presents significant hurdles, he said. Compliance is complicated and not without cost for the hospitals, and the funds are fairly limited, covering only a fraction of what hospitals and physicians provide in uncompensated care to these patients.

"If it's not worth it to hospitals, physicians are not likely to have the capacity to do so," he said.

The Centers for Medicare & Medicaid Services addressed the hospital community's comments and concerns in the final rule, said agency spokeswoman Mary Kahn. "The program is voluntary. If a hospital thinks the paperwork burden is too much, they don't have to participate," she said.

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