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  1. #1
    Senior Member Brian503a's Avatar
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    N.C. Supreme Court: Illegal immigrant not entitled to Medica

    http://www.myrtlebeachonline.com

    Posted on Fri, Apr. 07, 2006

    N.C. Supreme Court: Illegal immigrant not entitled to Medicaid

    STEVE HARTSOE
    Associated Press

    RALEIGH, N.C. - An illegal immigrant did not have an emergency medical condition when he received chemotherapy and Medicaid should not have been covered his treatment, the state Supreme Court ruled Friday in reversing a lower court decision.

    Medicaid only allows states to be reimbursed for Medicaid costs of illegal immigrants when medical treatment is deemed an emergency, according to court records.

    The N.C. Supreme Court noted a doctor who testified that without treatment Guatemala native Hector Diaz's condition eventually would have been an emergency. But his condition didn't meet that threshold during chemotherapy, the doctor said.

    Diaz's condition during chemotherapy "was stable and, therefore, he was no longer entitled to Medicaid coverage," the court said.

    Court documents say that in October 2000, Diaz came down with a sore throat, nausea, vomiting, and other ailments that were later diagnosed as symptoms of leukemia.

    He was treated at Moses Cone Memorial Hospital in Greensboro beginning that month, including intermittent chemotherapy treatments through July 2002.

    Diaz authorized the medical provider to seek Medicaid coverage but the state Division of Medical Assistance approved coverage for only a portion of his medical care that didn't include chemotherapy. The chief hearing officer of the North Carolina Department of Health and Human Services approved the decision.

    Diaz appealed to the Guilford County Superior Court, which reversed the state agency's decision.

    "Payment by Medicaid is not limited to emergency services; rather, Medicaid shall pay for all care and services as are medically necessary for the treatment of an emergency medical condition," the Superior Court ruled.

    The state appealed to the N.C. Court of Appeals, which unanimously upheld the trial court ruling in favor of Diaz.

    The state's highest court reviewed the decision and on Friday ruled in favor of the state, sending the case back to the Court of Appeals.

    Tom Cone, an attorney whose office in Greensboro represented Diaz, said he didn't believe the Supreme Court accurately interpreted the Medicaid statute.

    "We think that the statute says once a medical emergency is established then it should be treated and Medicaid ought to cover that treatment, not just for a set period of time," he said.

    Cone declined to comment on the status of Diaz and didn't know yet what would be the next step in the case.

    William Gheen, president of the Raleigh-based group Americans for Legal Immigration Political Action Committee, said covering chemotherapy was "a pretty close call because you may die without the chemotherapy."

    "The biggest question mark behind this court case is the negative impact on our entire hospital system caused by illegal immigration," he said.
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  2. #2
    Senior Member gofer's Avatar
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    NO American would have EVER gotten that chemotherphy. After people were cut off TNCARE (State program for the poor and uninsurable) in Tennessee, people's chemo was STOPPED during mid-treatment! [mod edit]

  3. #3
    ProudUsCitizen's Avatar
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    I thought the patient's name was Hector Diaz. Anyway, he's illegal and shouldn't be getting ANY free treatment.

  4. #4
    Senior Member gofer's Avatar
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    OOPS! Jumped the gun, there!

  5. #5
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    a doctor who testified
    Strange how they didn't actually use the doctor's name isn't it?

    I wasn't aware illegals were even eligible for Medicaid. All those hospital closures out west were because of non-reimbursed costs for treatment of illegals. Why didn't this hospital/doctor suck up the cost like those in California?

    And why, pray tell, must we read this story about a NC Court decision in MyrtleBeachon-line?
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  6. #6
    Senior Member Brian503a's Avatar
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    I strongly recommend not making accusations with a persons name based on ethnicity. It's not an image we want on Alipac of stereotyping people based on race.
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  7. #7
    Senior Member gofer's Avatar
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    Sorry Brian, point heard and taken!

  8. #8
    Senior Member Judy's Avatar
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    had_enuf said:

    And why, pray tell, must we read this story about a NC Court decision in MyrtleBeachon-line?


    Really!!!

    I think the big papers are pro-illegal and try to keep as much information from the public as possible. Most North Carolinians would be upset to find out MediCaid was paying for any of it!!

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  9. #9
    Senior Member Brian503a's Avatar
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    http://www.news-record.com/apps/pbcs.dl ... /604080303

    Article published Apr 8, 2006

    Court: Illegal Immigrant not entitled to benefits

    By Eric Collins
    Staff Writer
    GREENSBORO -- An illegal immigrant treated at a Greensboro hospital is not entitled to Medicaid benefits for chemotherapy because it didn't treat an emergency medical condition, the state Supreme Court unanimously ruled Friday.

    The precedent-setting decision overturned an N.C. Court of Appeals ruling that found that Medicaid coverage was appropriate because Hector Diaz would have died without chemotherapy.

    One of Diaz's attorneys said Friday that the court's decision could have significant impact on how much medical care providers give illegal and some legal immigrants. If they aren't reimbursed for care, they'll likely question whether to provide such services -- and at what cost, said Greensboro attorney Tom Cone.

    "Ultimately it raises issues of who we are as a society," Cone said. "Are we going to provide treatment for people like this or do we want our laws to simply say it's not our problem."

    Under federal and North Carolina regulations, illegal residents can't receive full Medicaid coverage unless the payments is for treatment of a "emergency medical condition."

    That can include emergency labor and delivery and severe pain that would likely put someone's health at great risk, according to court records.

    Diaz, a Guatemalan native, went to Moses Cone Hospital on October 2000, after suffering from days of nausea and vomiting, bleeding gums, sore throat and other maladies. He was diagnosed with a form of leukemia and began receiving chemotherapy treatments that continued intermittently until July 2002, court records indicate.

    The state Division of Medical Assistance approved Medicaid coverage for some of Diaz's medical bills but not those dealing with the chemotherapy treatments, which were deemed nonemergency services, court records said.

    After an administrative appeal failed, Diaz took the issue to a Guilford County Superior Court judge, who ruled in his favor in May 2003. The N.C. Court of Appeals upheld that ruling in September 2004, and the state appealed.

    In Friday's ruling, Justice Edward Thomas Brady wrote that while Diaz certainly had an emergency medical condition initially, that changed after his admission to the hospital.

    "During (Diaz's) chemotherapy treatments, his condition was stable and, therefore, he was no longer entitled to Medicaid coverage," Brady wrote.

    The ruling means Diaz will have to pay for the care not covered by Medicaid. His lawyer declined to say how much his client owes or anything personal about Diaz's health or financial situation.

    The state Attorney General's Office, which represented the state agencies in the case, declined to comment on the outcome Friday. The state division of medical assistance referred calls to the attorney general's office.

    Nolo Martinez, an official with the Center for New North Carolinians at UNCG, said he was disappointed by the ruling because he believed Diaz should get support from the state.

    The decision isn't going to change the need illegal immigrants have for health care, he said. However, he worries that hospitals might use it as a reason to turn such people away.

    In response to the ruling, Jim Whiting, vice president of oncology for the Moses Cone Health System, gave this statement: "Our health system treats everyone regardless of their ability to pay. We were acting in our patient's best medical interest, and we will continue to uphold our mission to our community."

    Contact Eric Collins at 373-7077, or ecollins@news-record.com
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  10. #10
    Administrator ALIPAC's Avatar
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