'This is a highly symbolic first step. The federal government is finally acknowledging that it has a responsibility to pay for health care provided to illegal immigrants.'

The money, totaling $1 billion, will be available for services provided from today through September 2008. Congress provided the money as part of the 2003 law that expanded Medicare to cover prescription drugs, but the new payments have nothing to do with the Medicare program.

Members of Congress from border states, like Sen. Jon Kyl, R- Ariz., had sought the money. They said the treatment of illegal immigrants imposed a huge financial burden on many hospitals, which are required to provide emergency care to patients who need it, regardless of their immigration status or ability to pay.

The largest allocations this fiscal year are going to California, which will receive $70.8 million; Texas, $46 million; Arizona, $45 million; New York, $12.3 million; Illinois, $10.3 million; Florida, $8.7 million; and New Mexico, $5.1 million.

Jan Emerson, a spokeswoman for the California Hospital Association, said California hospitals provided $500 million a year in emergency care for illegal immigrants, seven times the amount of the federal grant. But she welcomed the new assistance, saying: "This is a highly symbolic first step. The federal government is finally acknowledging that it has a responsibility to pay for health care provided to illegal immigrants."

Under the new program, hospitals are supposed to ask patients for certain documents to substantiate claims for payment. But Dr. Mark B. McClellan, administrator of the Centers for Medicare and Medicaid Services, said a hospital should not directly ask a patient "if he or she is an undocumented alien."

Instead, he said, hospitals can try to establish a patient's status by analyzing the answers to "indirect questions": Is the person eligible for Medicaid? (If so, payment is generally not available under the new program.) Has the person reported a foreign place of birth? Does the person have a border crossing card like those issued to Mexican citizens? Does the person have a foreign passport, a foreign driver's license or a foreign identification card?

The Bush administration abandoned a proposal that would have required many hospitals to ask patients if they were U.S. citizens or legal immigrants.

"In no circumstances are hospitals required to ask people about their citizenship status," McClellan said Monday.

Hospital executives and immigrant rights groups had said such questions would deter illegal immigrants from seeking hospital care and could lead to serious public health problems by increasing the spread of communicable diseases.

Cecilia Munoz, a vice president of the National Council of La Raza, a Latino civil rights group, said the new requirements were an improvement over the original proposal but would still discourage some immigrants from seeking treatment.

"Hospitals will have to ask confusing, highly technical questions about immigration documents," Munoz said. "That will create a perception in the Latino community that you have to show your papers in order to get emergency care. That's a misperception, but it may be enough to deter some people from seeking care."

The new program is run by the Department of Health and Human Services. McClellan said the department would not provide information about illegal immigrants to law enforcement officials for use in "routine civil immigration proceedings." But in rare cases, he said, the information may be used in criminal investigations.

Sen. Kay Bailey Hutchison, R-Texas, said she was pleased that the money was being made available, even as she called for new efforts to "secure our borders."

Before tapping the new program, hospitals and doctors must seek payment from other sources, like Medicaid and private insurers.

The Bush administration emphasized that hospitals "should not single out individuals who look or sound foreign for closer scrutiny."

"Hospital and other provider personnel may not selectively screen individuals regarding their eligibility status on the basis of race, color or national origin," the guidelines say.

Under the guidelines, hospitals are expected to make photocopies of documents indicating a patient's immigration status. They will not ordinarily have to submit such documents to the government, but must keep them for review by federal auditors.

© 2005 Daily Breeze. All rights reserved.
© 2005 Daily News Central. All rights reserved.