Tucson Region

ER compensation bill opposed

Hospital officials and immigration advocates are rallying to oppose a federal bill that would require emergency room doctors and nurses to collect and report information on the identity of suspected illegal entrants they treat. Not doing so would cause the hospital to risk receiving reimbursement for the unpaid bills illegal immigrants leave behind. Human rights and immigration advocates say "Undocumented Alien Reimbursement Assistance Amendments of 2004," H.R. 3722, which is sponsored by Republican California Rep. Dana Rohrabacher, is bad public policy. They say it makes all illegal entrants criminals and continues to ignore the inadequate compensation border hospitals receive under a misguided federal immigration policy. The bill, both sides concede, has little chance of passing. The bill would interfere with the doctor-patient relationship and could lead people to avoid treatment for fear of being turned in to immigration authorities, health officials say. Arizona hospital officials expect up to $40 million in reimbursements this year under an amendment successfully tacked onto the Medicare Prescription Drug, Improvement and Modernization Act of 2003 by Sen. Jon Kyl, R-Ariz. It sets $1 billion aside in compensation for hospitals that provide care to illegal entrants. Most of the money would go to the six states with the highest number of illegal entrants. It means $40 million in compensation could go to Arizona hospitals and ambulances, less than a third of the $150 million in unpaid bills Arizona health care providers are stuck with each year, said Laurie Lange, spokeswoman for the Arizona Hospital and Health Care Association in Phoenix. The bill, which is expected to go before the House for a vote next week, is intended to protect the American taxpayer, said Aaron Lewis, a spokesman for Rohrabacher, the congressman sponsoring the bill. "The bottom line is the United States can't afford to remain the HMO for the world. It has to look to the needs of legal residents first and foremost and the Congress needs to protect the interests of its citizens and taxpayers," he said. Lewis said health care professionals already collect and report to authorities evidence in cases that include domestic violence, child abuse and those involving gunshot wounds. Republican Rep. Jim Kolbe said Rohrabacher's effort to make medical staffers part of the law enforcement team is the wrong approach to solving a significant problem facing Southern Arizona. "Hospitals are already overburdened and all this does is make them do more paperwork in order to get reimbursed. The fact is they don't get reimbursed anyway," Kolbe said. The Arizona congressman said he doesn't expect Rohrabacher's bill will gain house approval. Rep. Raúl Grijalva, D-Ariz., said Rohrabacher's bill, which also requires hospitals to collect information on the individual's employer and holds the employer responsible for the cost of care, is mean-spirited. University Medical Center expects to see $10 million to $12 million in unpaid care for non-U.S. citizens this year, nearly 75 percent of whom are in the country legally. The hospital is lucky to collect even 1 percent of that amount, said Gregory Pivirotto, president and chief executive officer of the hospital. UMC already turns the names of nonpayers over to immigration officials, but that doesn't happen for seven days after treatment. Rohrabacher's legislation requires hospitals to assess the immigration status of patients and gather identifying information, like fingerprints and photographs, as they're treated.