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  1. #1
    Senior Member zeezil's Avatar
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    Hospitals fear loss of migrant-care funds

    Hospitals fear loss of migrant-care funds

    By Dale Quinn
    Arizona Daily Star
    Tucson, Arizona | Published: 09.14.2008

    Arizona hospitals spend millions every year on emergency care for illegal immigrants, and the federal government only reimburses a fraction of that cost.

    But even that money is at risk of drying up, though there should be enough to stretch into next year.

    The state's hospitals asked the federal government for about $180 million to help pay for urgent care for illegal immigrants between September 2006 and October 2007.

    They've gotten about $28.4 million reimbursed, thanks to Medicare money allocated to offset that cost. But now hospitals are in danger of losing that reimbursement, which usually covered about 15 percent of what the hospitals asked for.

    "There's enough money in the pipeline to pay hospitals for this care for another full year," said John Rivers, the CEO and president of the Arizona Hospital and Healthcare Association, which lobbies on behalf of the state's hospitals.

    About $77 million remains for Arizona hospitals from Medicare's Section 1011 funds because there's a delay in paying for services provided. The money was set aside to reimburse hospitals, certain physicians and ambulance providers for the expenses that come with providing urgent care for illegal immigrants. But Section 1011 will expire Sept. 30, and further action is required by Congress to extend the funds, Rivers said.
    "The bottom line is, we're going to have to make another run at this in 2009, and everyone is proceeding on that assumption," Rivers said.

    Must provide emergency care
    There's a federal mandate that hospitals provide emergency care for anyone who needs it — even if the patient can't pay.

    Hospitals in Tucson and Nogales asked for $33.3 million and got back $5.8 million in fiscal year 2007, which runs from Oct. 1 to Sept. 30.
    "We're going to take care of these people no matter what, and we wish (Section 1011) would be renewed," said University Medical Center CEO Greg Pivirotto. "It's not a Tucson problem. It's not an Arizona problem. It's a federal problem."

    Of Tucson-area hospitals, UMC, which has the only level-one trauma center in Southern Arizona, spends the most on emergency care for illegal immigrants. The hospital, at 1501 N. Campbell Ave., asked for more than $11 million in federal fiscal year 2007.

    The reimbursement was about $1.9 million, Pivirotto said. This year it already looks like the hospital is going to incur high costs on urgent care for illegal immigrants, he said. Between January and June, UMC provided care for roughly twice as many illegal immigrants as it did during the same period in 2007.

    Earlier this year, vehicles packed with illegal immigrants rolled on several occasions, injuring dozens. Those patients were sent to local hospitals, some with serious injuries.

    Pivirotto said the spike in illegal immigrants treated at UMC could be directly attributed to those accidents.

    UMC does not report illegal immigrants to the Border Patrol because that would discourage people from getting the care they need, according to an e-mail from hospital spokeswoman Katie Riley.

    UMC's fiscal year begins in July, and this year the hospital planned its budget under the assumption that the funds wouldn't be renewed, Pivirotto said. That and other cuts in the budget force the hospital to improve efficiency and work toward increasing the number of patients seen there, he said.

    TMC reimbursed for fraction
    Even without federal support, Tucson Medical Center, at 5301 E. Grant Road, will treat all patients regardless of their ability to pay or their immigration status, said spokeswoman Julia Strange.

    "We're a hospital. Our mission is to take care of the people that come to us, not enforce immigration policy," she said.

    TMC asked for $4.5 million and received $867,324 in 2007 — better than nothing, Strange said.

    "The funding from the federal government has helped hospitals in the border region deal with these patients," Strange said.

    Losing the money would mean the hospital would have to tighten the budget in other areas, but Strange could not speculate what other areas might be cut.

    In 2007, TMC cut about 480 positions from its budget in an effort to reverse big losses, but this year the company had improved its financial outlook with a string of profitable months.

    Carondelet Health Network, which runs St. Mary's and St. Joseph's hospitals in Tucson and Holy Cross Hospital in Nogales, is also bracing for the impact of losing the funds.

    "It creates a financial burden in general," said Bill Pike, Carondelet's director of public policy. Pike said the Medicare reimbursement folds into the larger issue of caring for the uninsured, which ends up costing everyone, from individuals to employers.

    Law enacted in 2003
    The money for the reimbursement was set aside in a Medicare act passed by Congress in 2003. The act included $250 million in reimbursements for fiscal years 2005 to 2008. The largest chunk of money goes to California, which was allocated $72.2 million this fiscal year. Arizona and Texas follow with $44.7 and $44.4 million, respectively.

    But that money only covers what's mandated by the Emergency Medical Treatment and Labor Act, which requires hospitals to treat and stabilize patients who require urgent care.

    Hospitals still have to pay any inpatient costs if patients require additional care.

    When hospitals have patients from foreign countries who require additional treatment, hospital officials said they work with the appropriate consulate or family members.

    There's still a chance that Congress can renew the funding next year, but it's not a "slam dunk," said Rivers, who was in Washington, D.C., last week working with legislators.

    Getting it taken care of this year was challenging because it deals with a contentious issue legislators tend to shy away from during an election year, he said.

    "It's a very difficult issue for Congress to deal with because it touches on the immigration issue, which is a big hot potato in D.C.," Rivers said.
    Rivers was optimistic the funds could be renewed, especially because the health-care cost of illegal immigration is becoming a national issue, not just one in border states.

    â—
    Join our efforts to Secure America's Borders and End Illegal Immigration by Joining ALIPAC's E-Mail Alerts network (CLICK HERE)

  2. #2
    Senior Member miguelina's Avatar
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    This is taxpayer money and should not be used for illegal aliens. We have millions of Americans who are denied care because they can't pay; but illegal aliens must be treated on our dime? Hell no! This needs to be stopped. This federal mandate must be overturned also. How is it illegal aliens are allowed to ignore our laws, but Americans HAVE to obey them? I'm sick and tired of getting screwed!
    Join our efforts to Secure America's Borders and End Illegal Immigration by Joining ALIPAC's E-Mail Alerts network (CLICK HERE)
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