Access records may help recover $2.9 million

Records document Border Patrol abuse of law

San Diego County health care providers incurred more than $2.9 million in unreimbursed charges for emergency medical treatment involving unauthorized immigrants and the U.S. Border Patrol between January 1996 and May 1997, according to a 1997 report by the California Bureau of State Audits.

Those charges were associated with 199 incidents involving injured unauthorized immigrants and Border Patrol agents who arrived at the scene either at the time the injuries were discovered or soon after, the report states. "In all cases, Border Patrol agents had an opportunity to assess whether the injured were unauthorized immigrants and whether to take them into custody — either immediately or following medical treatment," the report continues.

Health care providers are adversely affected, the report explains, by the Border Patrol’s seemingly illogical policy of paying the emergency care charges only for unauthorized immigrants already in its custody at the time of treatment. It is the Border Patrol’s policy not to take injured suspects into custody because they are "unlikely to escape."

The report questions the logic of that policy, pointing out that although injured suspects may be deemed unlikely to escape and thus avoid immediate apprehension, this status appears temporary in most instances.

"Given that in over 70% of the incidents we analyzed, the suspects were treated on an outpatient basis," the report continues, "it seems logical to have some form of prompt follow-up contact to reconsider custody." Instead, the report quotes a Border Patrol spokesman as saying an agent "generally does not make hospital calls" unless the patient was already in custody or "under suspicion."

"We believe," the report concludes, "that if suspects’ injuries were the only reason they were not taken into immediate custody, then all such people should be considered under suspicion.’"

Actual unreimbursed charges for such cases, many of which were not identified, are likely much higher than $2.9 million — amounting to another $2 million to $5.2 million — the report estimates.

Closely monitor and document

Similar situations exist in other border areas, suggests Jack Duffy, FHFMA, corporate director for patient financial services for Scripps-Health in San Diego. Those situations present an opportunity for access managers to make strides toward getting better reimbursement for their organizations.

Closely monitoring and documenting incidents involving illegal aliens could help lead not only to more reimbursement in the short term, but also to beneficial political changes, he says.

"[City or state officials] might be hesitant to rock the boat if they think something is an isolated incident," Duffy says, "but if you can show that it happened 23 times and cost $160,000, that’s another story."