The CMS proposed an implementation plan for how it would distribute extra payments to hospitals that treat a large number of illegal immigrants in their emergency rooms, carrying out a provision of last year's Medicare reform law. The Medicare law set aside $1 billion over four years to help hospitals absorb the cost of treating illegal immigrants, with $250 million to be distributed annually from 2005 through 2008. Under the CMS proposal, two-thirds of the money would be allocated based on each state's estimated share of the nation's undocumented immigrants. The remaining one-third would go to the six states with the largest number of undocumented immigrant apprehensions. Led by California, where hospitals are likely to receive $72.4 million in 2005, those states also include Texas, Arizona, New York, Illinois and Florida, listed in descending order of total apprehensions. The CMS would make quarterly payments directly to individual hospitals, which could begin submitting claims Jan. 1, 2005.
Under the CMS proposal, hospitals would have to document the number of illegal immigrants they treat in order to receive funds. That would involve asking all patients their citizenship status, something that hospitals have said would further burden already strained emergency departments. The CMS is accepting comments on the proposed implementation plan through Aug. 16 and hopes to issue a final version by Sept. 1. Payments to hospitals would cover emergency room expenses and related care, such as ambulance or physician services, CMS Administrator Mark McClellan said. Read the CMS proposal. -- by Jeff Tieman