Thread: Many health providers bypassing U.S. fund for entrant-care c

Published: 09.20.2006

Many health providers bypassing U.S. fund for entrant-care costs
By Lourdes Medrano
ARIZONA DAILY STAR
Emergency medical care for illegal border crossers leaves hospitals and other health-care providers with large unpaid bills, but federal officials are at a loss to explain why a controversial $1 billion federal program created to reimburse them has largely gone unclaimed.
Of a potential $47 million that health-care providers in Arizona are eligible to receive, the government has approved only $5.1 million, government figures show.
Several hospital officials in Tucson and Southern Arizona say their hospitals get reimbursed for expenses associated with treating illegal immigrants. But some noted that the complexity of what is a fairly new application process may be keeping other hospitals from seeking the funding.
"A lot of people don't think it's worth the effort," said James Dickson, chief executive officer at the Copper Queen Community Hospital in Bisbee. "It's a lot of work for 15 cents on the dollar."
For the hospital, that translates into about $400 for the monthly bill of about $4,000 that was sent to the federal government in August.
Emergency-care cost for foreign nationals totals between $50,000 and $60,000 a year at the Bisbee hospital, a drop from the roughly $450,000 it provided just a couple of years ago. Dickson attributed the decline mostly to beefed-up border enforcement, which has pushed the flow of illegal border crossers away from the area.
Although the government does not cover all expenses, Dickson said, "We're very happy we don't have to provide care for free."
University Medical Center incurred an annual loss between $4 million and $5 million treating foreign nationals in the fiscal year ending in June, said Kevin Burns, chief financial officer for the hospital. The previous year, it was about $3.5 million, he said.
And even though the funding program covers only part of the medical costs, Burns said, "it is an important recognition by the federal government that they have responsibility for the border."
It would be inappropriate to not take advantage of the funding, he said, but he acknowledged that initiating the application process can be cumbersome. "As with any new process, it was a challenge for our team to get it set up properly."
So far, UMC has received about $1.5 million in federal funding through December 2005, Burns said. "It's not covering all our costs, but we're appreciative of having some assistance."
Tucson Medical Center and Carondelet Health Network hospitals in Tucson and Nogales also have applied for the federal funding, officials said, but they could not provide specific amounts Tuesday.
Nationally, only 15 percent of the money has been handed out three-quarters of the way through the program's first year.
"We are really not certain why providers are not claiming the money," said Herb Kuhn, head of the government's Center for Medicare Management, which administers the program intended to distribute the $1 billion between 2005 and 2008.
Sen. Jon Kyl, R-Ariz., a key supporter of the funding, has been trying lately to find out why so little money has been used. "What is frustrating to me is that there is no constant response from the hospitals in Arizona to tell us what's happening," Kyl said.
In the meantime, some say the money should go elsewhere.
"Providing illegal aliens with free health care is an incentive for more illegals to come here," said Rep. Dana Rohrabacher, R-Calif., one of the louder voices today calling for tougher immigration policies.
"Draining limited health-care funds to take care of illegal aliens and reimburse hospitals for their emergency care is ill-conceived and harmful to our own citizens. I will continue to oppose this kind of nonsense," he said last week.
While federal officials search for answers for the program's slow start and say they are optimistic it will work out, hospital officials, public health experts and immigrant advocacy groups offered several explanations.
The biggest deterrent to applying for the money, they explain, is concern about time-consuming paperwork that can offset any money gained.
Another is how the government calculates costs and often dramatically trims hospital bills. Federal officials say the cuts take place because hospitals often bill for their services and not their costs, and in some cases, seek funds for longer periods of stay than allowed.
Another problem for some is more of a moral issue, a concern by hospital officials that questions about immigration status will scare off already worried immigrants.
These hospitals are uneasy with the requirement that they document whether their patients are eligible for the federal money. It's an awkward process, the hospital officials say. They are told not to ask if someone is undocumented but to seek proof of birth outside the U.S. such as a driver's license, passport or birth certificate.
And though the federal form says patients' information will not be provided to immigration officials — except in cases involving suspected terrorism or crimes — some immigrant advocacy groups and health-care providers are skeptical of such promises.
Saying it wanted to protect patients' confidentiality about their immigration status, for example, New York City's health network, the nation's largest public health system, announced in November 2005 that it would forgo the federal money.
But federal officials were not aware of New York City's position last week when initially asked why less than $100,000 has been spent so far out of the $15.1 million available in New York state. They later acknowledged the New York City hospitals' confidentiality concerns and "strong immigrant advocacy" in New York that views the documentation as "onerous."
Kyl also helped provide U.S. funds for a 2002 study that put the cost of unpaid emergency care bills for undocumented immigrants at about $190 million alone for hospitals along the nation's border with Mexico.
Hospitals' disinterest in the program comes at a time when many facilities are calling for more government support to help them deal with a growing number of poor and uninsured patients unable to pay their medical bills.
Earlier this month, the U.S. Census Bureau reported the number of uninsured Americans rose last year to a record 46.6 million, 15.9 percent of the total population. Meanwhile, the medical care that hospitals write off continues to soar.
"There are hospitals that say, 'I am only going to get 33 cents on the dollar and then I have to hire people to complete these forms and house them.' They say it's not worth the effort," said Carla Luggiero, senior associate director for federal relations at the American Hospital Association.
"On the other hand, something is better than nothing so we are going to do it. There is a schism there," she added.
On StarNet Get more information on the problem of illegal immigration and preview the Star's upcoming border series at azstarnet. com/border
● The Chicago Tribune contributed to this story. ● Contact reporter Lourdes Medrano at 573-4347 or lmedrano@azstarnet.com.
http://www.azstarnet.com/sn/printDS/147464

What difference does this make anyway? It is still the
American citizenry that pays these bills, in one way or another.

Exactly. But as with most things......there's minimul they (the government)have to do to get your money but a whole lot of hoops to jump in order to get the money back.