A coalition of Florida hospitals is challenging a state policy on emergency care for undocumented immigrants.
The coalition, which includes Broward Health and Memorial Healthcare System in Hollywood, says the state Agency for Health Care Administration has been unlawfully limiting payments to hospitals that provide emergency services to undocumented immigrants.
“There clearly is a federal intent that these hospitals be paid, and the state is supposed to follow it,” said Joanne B. Erde, a Miami attorney representing the hospitals. “It is a condition of participating in the Medicaid program.”
The state Agency for Health Care Administration, or AHCA, says it is has followed the law.
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“We believe the agency is in compliance with federal and state laws with regard to payment of claims for undocumented aliens,” spokeswoman Shelisha Coleman said.
Hospitals in states that participate in Medicaid, the joint state-federal health insurance program, are required to treat undocumented immigrants in emergency medical situations.
In Florida, hospitals are reimbursed for those services by AHCA.
AHCA used to pay for all emergency care for undocumented immigrants deemed “medically necessary,” according to a petition filed in the Division of Administrative Hearings last week by the hospitals. But since 2010, the agency has been paying only to the point of “alleviation” or “stabilization.”
The hospitals argue that those guidelines keep AHCA from paying for many critical services.
They also contend that AHCA has “no statutory authority to limit the duration of an undocumented alien’s emergency medical condition.” That authority falls to the state Department of Children and Families, according to the petition.
The hospitals characterize AHCA’s policy as “arbitrary and capricious.” Erde, the attorney for the hospitals, said it is hurting her clients’ bottom lines.
“Hospitals are stressed,” she said. “Everybody is paying them less and less.”
Other hospitals in the coalition include the Lee Memorial Health System and hospitals in the Tenet Healthcare Corporation.
A hearing has been set for Nov. 12 and 13 in Tallahassee.
Contact Kathleen McGrory at kmcgrory@MiamiHerald.com.