Medicare Compliance & Reimbursement

Medicare Modernization Act:

Undocumented-Alien Treatments Could Land Pay

EMTALA funding available until 2008.

Hospitals can receive direct payments from their states for some or all of their emergency healthcare costs and related inpatient, outpatient and ambulance services provided to undocumented aliens.
 
The Medicare Modernization Act Section 1011, titled "Federal Reimbursement of Emergency Health Services Furnished to Undocumented Aliens," provides funding for physicians, state-licensed ambulance service providers, and Medicare participating hospitals, including critical access hospitals, from fiscal years 2005 to 2008, according to a May 9 Centers for Medicare and Medicaid Services final policy notice update. Hospitals can receive payments under section 1011 only for services not otherwise reimbursed during the given FY. The funding applies to emergency services provided to undocumented aliens, aliens paroled into the country at a U.S. port of entry to receive eligible services, and Mexican citizens permitted U.S. entry for 72 hours.
 
Exceptions: Federally Qualified Health Centers and mid-level practitioners, including nurse practitioners, physician assistants and clinical nurse specialists, cannot receive this funding.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Medicare Compliance & Reimbursement

View All