http://www.startribune.com/462/story/367264.html

Last update: April 12, 2006 – 8:56 PM

Audit finds health care eligibility errors
The study did not determine whether the errors unfairly restricted or improperly provided benefits to immigrants.
Jean Hopfensperger and Terry Collins, Star Tribune

Health care workers consistently make mistakes when determining whether immigrants should qualify for taxpayer-funded medical care, the state legislative auditor said Wednesday.

Auditors found that more than 70 percent of the immigrant cases they examined contained processing errors and that 18 percent had errors affecting immigrants' eligibility for benefits. The study did not determine whether the errors unfairly restricted or improperly provided benefits to immigrants.

In half the cases, county workers did not check immigrants' legal status with an electronic verification system, which is required by state law.

The cost of providing health care and other benefits to illegal immigrants has become a central argument of critics of current immigration policy. According to the audit, the vast majority of immigrants receiving health care benefits (80 percent) were legal.

Still, the government spent $37 million on health care for illegal immigrants in Minnesota last year. The state's share was $18 million.

Most of the money went to women for prenatal, maternity and postnatal care. The rest went to patients who sought emergency care.

"It's clear this is a complicated system and that the error rate is significant," said Sen. Ann Rest, DFL-New Hope, chair of the Legislative Audit Commission.

"But it is mostly worker error," she said, and there was no indication of fraud or other serious problems.

The audit examined non-citizen immigrants' use of Medical Assistance, General Assistance Medical Care and the Refugee Medical Assistance program in 2005. It also pulled out 137 cases for detailed examination.

The audit didn't find any smoking guns. But it points to the need for further study, said Rep. Tim Wilkin, R-Eagan, vice chair of the commission.

"I think we need to dig down," Wilkin said. "Do we need more training for county workers? Is sloppiness going on? Are there people knowingly looking the other way to put people [illegal immigrants] in programs?"

Jim Noble, the state auditor, attributed the problems to the complexity of determining which immigrants are eligible for which benefits. Each health care program has different rules. And there are at least a dozen categories of noncitizens -- ranging from foreign students to refugees to armed forces veterans. Each group is entitled to different benefits.

Some clinics are determined to offer health care, regardless of whether a patient entered the country illegally.

At the fiscally strapped La Clinica en Lake on E. Lake St. in Minneapolis, a steady stream of patients, many undocumented, waited to be seen Wednesday.

Nearly 80 percent of its 5,000 patients are uninsured, and getting them to show up is half the battle, said Dr. Carlos Figari.

He said many of its patients are afraid to seek health care because of their status.

"We're a safety net for them," said Figari, who specializes in family medicine. "They already have a high level of anxiety. They are scared because immigration is a hot-button issue."

Figari said with increased health care costs and cuts in state and federal funding, providing service has put their clinic in financial trouble.

"The clinic will never turn people away, regardless of their payment capabilities," Figari said.

Two bills making their way through the House would shape future spending on immigrant health care. One bill, authored by Rep. Fran Bradley, R-Rochester, would require county workers to notify immigration officials if an illegal immigrant applied for health benefits.

Another bill, by Rep. Tom Emmer, R-Delano, would eliminate state funding of prenatal care for women who are illegal immigrants.


hopfen@startribune.com • 612-673-4511 tcollins@startribune.com • 612-673-1790