Illegal Immigrants’ Emergency Care Is Limited by U.S. Rule
SuzannePjam
Posts: 411
I had no idea illegal immigrants could get emergency chemotherapy care. For the full article click on the link.
http://www.nytimes.com/2007/09/22/washington/22emergency.html?_r=1&hp=&adxnnl=1&oref=slogin&adxnnlx=1190460905-bfC2L2pdBesf+ZBIkrZdgQ
Immigrants’ Emergency Care Is Limited by U.S. Rule
By SARAH KERSHAW
Published: September 22, 2007
The federal government has told New York State health officials that chemotherapy, which had been covered for illegal immigrants under a government-financed program for emergency medical care, does not qualify for coverage. The decision sets the stage for a battle between the state and federal governments over how medical emergencies are defined.
The change comes amid a fierce national debate on providing medical care to immigrants, with New York State officials and critics saying this latest move is one more indication of the Bush administration’s efforts to exclude the uninsured from public health services.
State officials in New York and other states have found themselves caught in the middle. The New York dispute, focusing on illegal immigrants with cancer — a marginal group of unknown size among the more than 500,000 people living in New York illegally — has become a flash point for health officials and advocates for immigrants in recent weeks.
Under a limited provision of Medicaid, the national health program for the poor, the federal government permits emergency coverage for illegal immigrants and other noncitizens. But the Bush administration has been more closely scrutinizing and increasingly denying state claims for federal payment for some emergency services, Medicaid experts said.
Last month, federal officials, concluding an audit that began in 2004 and was not challenged by the state until now, told New York State that they would no longer provide matching funds for chemotherapy under the emergency program. Yesterday, state officials sent a letter to the federal Medicaid agency protesting the change, saying that doctors, not the federal government, should determine when chemotherapy is needed.
Federal health officials declined to discuss chemotherapy or the New York claims. But Dennis Smith, director of the Center for Medicaid and State Operations at the federal Centers for Medicare and Medicaid Services, said in a statement, “Longstanding interpretations by the agency have been that emergency Medicaid benefits are to cover emergencies.”
The federal statute that defines an emergency under Medicaid makes it clear that routine care for illegal immigrants and nonresidents, including foreign students and visitors, is not covered. But the only procedures it specifically excludes from reimbursement are organ transplants, leaving to the states the task of further defining an emergency. States and courts have grappled with the question for years, yielding no clear definition.
Some states have maintained that any time a patient is able to schedule an appointment — as opposed to showing up at an emergency room — the condition would not be considered an emergency. Others, including New York, have defined an emergency as any condition that could become an emergency or lead to death without treatment.
“There are clearly situations that we consider emergencies where we need to give people chemotherapy,” Richard F. Daines, the New York State health commissioner, said in an interview late yesterday. “To say they don’t qualify is self-defeating in that those situations will eventually become emergencies.”
Dr. Daines said that for every effort in the state to use Medicaid “creatively” to cover the uninsured, “the Bush administration, at every chance, is pushing it back.”
The state estimated that the federal government denied $60 million in matching funds for emergency Medicaid from 2001 to 2006, including $11.1 million for chemotherapy. Medicaid costs are typically split evenly between the state and the federal government.
It is unclear how many other states are providing chemotherapy to illegal immigrants, because all emergency services are generally lumped together in state Medicaid reports. But others have also been challenged on emergency Medicaid claims.
In Washington State, where illegal immigrants are entitled to Medicaid coverage for a month or more after treatment in an emergency, officials said a federal audit of their emergency Medicaid claims was under way, and the state has asked the federal government to provide a definition of emergency services.
“The awkward position state Medicaid programs are in is trying to figure out what kinds of medical care should be available for emergency conditions,” said Douglas Porter, assistant secretary for the Washington Health and Recovery Services Administration.
Washington and other states have also fought the federal government over Medicaid for infants born to illegal immigrants, an issue reflected in the ferocious debate over the national children’s health insurance program.
In the wake of stricter federal rules, New York, New Jersey, Connecticut and 20 other states have extended full Medicaid coverage, using only state money, to some immigrants who do not qualify for federal aid. Under federal law, proof of citizenship is required for full Medicaid coverage, but not for emergency coverage.
http://www.nytimes.com/2007/09/22/washington/22emergency.html?_r=1&hp=&adxnnl=1&oref=slogin&adxnnlx=1190460905-bfC2L2pdBesf+ZBIkrZdgQ
Immigrants’ Emergency Care Is Limited by U.S. Rule
By SARAH KERSHAW
Published: September 22, 2007
The federal government has told New York State health officials that chemotherapy, which had been covered for illegal immigrants under a government-financed program for emergency medical care, does not qualify for coverage. The decision sets the stage for a battle between the state and federal governments over how medical emergencies are defined.
The change comes amid a fierce national debate on providing medical care to immigrants, with New York State officials and critics saying this latest move is one more indication of the Bush administration’s efforts to exclude the uninsured from public health services.
State officials in New York and other states have found themselves caught in the middle. The New York dispute, focusing on illegal immigrants with cancer — a marginal group of unknown size among the more than 500,000 people living in New York illegally — has become a flash point for health officials and advocates for immigrants in recent weeks.
Under a limited provision of Medicaid, the national health program for the poor, the federal government permits emergency coverage for illegal immigrants and other noncitizens. But the Bush administration has been more closely scrutinizing and increasingly denying state claims for federal payment for some emergency services, Medicaid experts said.
Last month, federal officials, concluding an audit that began in 2004 and was not challenged by the state until now, told New York State that they would no longer provide matching funds for chemotherapy under the emergency program. Yesterday, state officials sent a letter to the federal Medicaid agency protesting the change, saying that doctors, not the federal government, should determine when chemotherapy is needed.
Federal health officials declined to discuss chemotherapy or the New York claims. But Dennis Smith, director of the Center for Medicaid and State Operations at the federal Centers for Medicare and Medicaid Services, said in a statement, “Longstanding interpretations by the agency have been that emergency Medicaid benefits are to cover emergencies.”
The federal statute that defines an emergency under Medicaid makes it clear that routine care for illegal immigrants and nonresidents, including foreign students and visitors, is not covered. But the only procedures it specifically excludes from reimbursement are organ transplants, leaving to the states the task of further defining an emergency. States and courts have grappled with the question for years, yielding no clear definition.
Some states have maintained that any time a patient is able to schedule an appointment — as opposed to showing up at an emergency room — the condition would not be considered an emergency. Others, including New York, have defined an emergency as any condition that could become an emergency or lead to death without treatment.
“There are clearly situations that we consider emergencies where we need to give people chemotherapy,” Richard F. Daines, the New York State health commissioner, said in an interview late yesterday. “To say they don’t qualify is self-defeating in that those situations will eventually become emergencies.”
Dr. Daines said that for every effort in the state to use Medicaid “creatively” to cover the uninsured, “the Bush administration, at every chance, is pushing it back.”
The state estimated that the federal government denied $60 million in matching funds for emergency Medicaid from 2001 to 2006, including $11.1 million for chemotherapy. Medicaid costs are typically split evenly between the state and the federal government.
It is unclear how many other states are providing chemotherapy to illegal immigrants, because all emergency services are generally lumped together in state Medicaid reports. But others have also been challenged on emergency Medicaid claims.
In Washington State, where illegal immigrants are entitled to Medicaid coverage for a month or more after treatment in an emergency, officials said a federal audit of their emergency Medicaid claims was under way, and the state has asked the federal government to provide a definition of emergency services.
“The awkward position state Medicaid programs are in is trying to figure out what kinds of medical care should be available for emergency conditions,” said Douglas Porter, assistant secretary for the Washington Health and Recovery Services Administration.
Washington and other states have also fought the federal government over Medicaid for infants born to illegal immigrants, an issue reflected in the ferocious debate over the national children’s health insurance program.
In the wake of stricter federal rules, New York, New Jersey, Connecticut and 20 other states have extended full Medicaid coverage, using only state money, to some immigrants who do not qualify for federal aid. Under federal law, proof of citizenship is required for full Medicaid coverage, but not for emergency coverage.
"Where there is sacrifice there is someone collecting the sacrificial offerings."-- Ayn Rand
"Some of my friends sit around every evening and they worry about the times ahead,
But everybody else is overwhelmed by indifference and the promise of an early bed..."-- Elvis Costello
"Some of my friends sit around every evening and they worry about the times ahead,
But everybody else is overwhelmed by indifference and the promise of an early bed..."-- Elvis Costello
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if you're not here legally; you don't deserve anything. these illegals do get free health services when they sneek accross the border to birth an american citizen. then they get welfare and medicaid; among other benefits. others show up at the emergency room and cannot be turned away.
if your state gives medicaid and other services to illegals; you have the answer to why you don't have free healthcare coverage. close to 14 million illegals are sucking the system dry. canada has socialized medicine but i'm pretty sure you must prove you're a canadian citizen to receive it. otherwise people would be traveling to canada for free medical care. when i travel to other countries i have to pay to see a doctor while the citizenship gets free medical services.
why does the us get bashed when they do (or try to do) what other countries consider policy?
If the tax structure were to change to say... the fair tax, this money wouldn't be an issue because it'd be there, not to mention because they are undocumented they wouldn't get the prebate....so there's a substantial penalty to not becoming a citizen.
I still blame corporations more for hiring illegals, than illegals for taking the jobs. Lock up the corporation for illegally hiring labor and sieze a few businesses and a lot of these issues will slow down and more people will seek to become citizens of the US and start paying into the system so there aren't cash flow problems.
we are going after the employer:
http://seattlepi.nwsource.com/local/...igrants. html
http://www.azcentral.com/arizonarepu...pact08260.html
http://www.iht.com/articles/ap/2007/...-Sanctions.php
but isn't it better for a person to stay undocumented? let's consider the average drug dealer. you buy a pound of pot for $650.00 and sell it in quarters for just under $4000.00. the drug dealer isn't paying taxes on that money. if he's smart and knows how to launder the money; he'll be able to retire in about 10 years. paying tax on the money he uses that year.
so the point is; those legally employed have to pay for those who don't pay taxes. this is where the socialized medicine debate begins. are the legally employed willing to pay almost twice as much in taxes to pay for healthcare for those who don't? if you ask the businesses to pay more; they cut employees. i've done it every time the government came up with a "must supply" benefit law.
Here's my plan.
Bill Mexico.
...
What? They are from Guatemala or El Salvador? Don't care, they crossed in from your country... pay the bill.
What? You don't have the money? Fine, we'll deduct it from that 'Foriegn Aid' we funnel into your president's personal bank account until you do something to fix your country.
Hail, Hail!!!
exactly, which is why we need to completely restructure the tax system.
Verona??? it's all surmountable
Dublin 23.08.06 "The beauty of Ireland, right there!"
Wembley? We all believe!
Copenhagen?? your light made us stars
Chicago 07? And love
What a different life
Had I not found this love with you
no, whether you are legal or illegal you will be treated. Poor and old or disabled people in the US are already covered by a form of socialized medicine called Medicare. In addition the SCHIP program handles additional insurance for children outside the poverty level. Illegals (and anyone else uninsured) going into emergency rooms are covered by the government also (or hospitals simply have to eat the cost which is why so many of them have financial problems in big cities)
Aparently the discussion here is on whether or not Chemo can or should be administered in the Emergency ward at all.
I am not sure about the rules. I have anectodal evidence.
When we went to see Pearl Jam in London, ON, my friend was hit by a car. We went to the ER and they took care of her. She didn't have to pay a thing.
When we were in Italy a few years ago, my husband had a heart issue. They did CAT scans, MRIs, to make sure he was ok. He is an Italian citizen, but they didn't even ask his name.
In countries where medicine is not a business people care about you being healthy more than about making a buck. It's all a matter of perspective and, to quote the wealthy Canadian on the golf course in Sicko, "taking care of each other", and having each other defined by humanity and not nationality.
I was proud to read yesterday in a NYC hospital how many services are indeed provided to human beings regardless of a number of things, including legal status.
This shit about "you are not able to pay so we don't give a shit if you die" truly sickens me. And don't give me the "well what would happen if no one paid?" crap. There is more than enough wealth in this country to take care of everyone, foreign policy screwups and all.
CArry on.
Verona??? it's all surmountable
Dublin 23.08.06 "The beauty of Ireland, right there!"
Wembley? We all believe!
Copenhagen?? your light made us stars
Chicago 07? And love
What a different life
Had I not found this love with you
That is pretty much the basics of it, although on top of proving you are a citizen you have to have a valid government health card (there was a story in Ontario awhile back about a guy who went to a clinic because he wasn't feeling very well, they turned him away because his health card wasn't valid and on the way from the clinic to the health office to get it renewed he diad of a heart attack). A lot of clinics have signs up saying they won't see you without a card, and I have seen signs at both clinics and hospitals saying people without cards will be billed for services (although I am pretty sure hospitals are required to treat you either way).
america has wealth for those willing to work and poverty for those who choose not to work.
quoting sicko ruins your credability. sicko is mostly fictional. you may as well quote star wars.
i will not work for others because they will not work for me. being self employed i can adjust my income so i pay almost nothing in taxes. busineses can buy equipment or reinvest to avoid taxes. it's the blue collar worker that must carry the burden if we are to have socialized medicine. if they are ready to carry that burden; i'm all for it. as long as i can keep my insurance and use the doctors i choose. similar to the reforms some in canada are trying to pass. if you can afford top rate healthcare it should be available to you. those who can't; can wait in clinics.
people need to earn what they have. this isn't sherwood forest where robin hood takes from the rich and gives to the poor. if you want to take from society; you also need to contribute.
I'm white, love filet mignon...and I'm uninsured...hmm...?
he was being sarcastic. that's the usual "race card" response. i have several doctors and not one is white. they're insured and eat better than kings (because they buy their meat from me).
Sicko is not fiction. Other than maybe the Cuba section. It is the description of my personal experience with the Italian system for as long as I have lived.
Your assumption that undocumented immigrants don't work or that they are all drug dealers is ludicrous. I live in NYC. This city would collapse in less than two hours if these people stopped working.
Personally I like the concept that even though I have a job today I might lose it tomorrow, but whether I have a job or not if I get into a car accident and need brain surgery I won't be in debt for the rest of my life trying to pay it off.
I also believe as you do... and that the strong should help the weak... instead of pummelling them because they are weak.
Hail, Hail!!!
that reminds me i need to go point and laugh at the homeless guy down the street. now where did i put my pastel sweater vest...
first; this is not italy. americans wouldn't pay the taxes you pay. i'd like to see where i said illegals don't work. they do work. they don't contribute to society but they work. since you live in nyc; i'm sure you can find a crack dealer within minutes. we see it on the news here all the time.
if nyc would collapse in 2 hours if the illegals stopped working; then nyc is a big reason we don't have socialized medicine. look at all the money nyc pours into social services. look at the amount spent on welfare alone.
we have laws and rules for entering this country. why would anyone advocate violating the law? if you add up all the costs spent on illegals; including what is spent at the borders; all americans could have free healthcare. on the other hand; if 14 million people were dropped in italy; it's healthcare system would crumble. especially if those 14 million also needed welfare and the other services they receive in the us. this is why countries control immigration.
lastly; you tell me how wonderful it was in italy; but you live in nyc. that in itself says it all.
that's why we have medicare and medicaid. i was given 4 to 8 weeks to live because of internal bleeding. i got medicare. my medications cost $3200 USD per month but i contacted the manufacturers who all have programs to help those without prescription coverage and the total cost to me per 3 month period is $80. USD. i couldn't ask for better than that.