Arizona Patient Advocacy Group Argues in Court to Retain Medicaid Dialysis Coverage for Immigrants

Arizona should continue to pay for regular dialysis treatments administered in emergency rooms to undocumented immigrants despite a state order that the services should only be covered in "true emergencies," a lawyer representing undocumented immigrants argued in U.S. District Court on June 13, the AP/Arizona Republic reports (AP/Arizona Republic, 6/14). A lawsuit filed in April by the William E. Morris Institute for Justice alleges that officials of the Arizona Health Care Cost Containment System, the state's Medicaid program, violated federal policy by restricting Medicaid coverage of dialysis treatments for legal immigrants. Arizona had covered the cost of the treatment for 159 immigrants through use of federal funds and a state emergency services program for individuals who do not qualify for Medicaid coverage. However, under a guidelines clarification issued in November 2001, dialysis and some other medical services now are considered treatments for chronic conditions and not emergencies (Kaiser Daily Health Policy Report, 4/8). As a result, $3 million in temporary state funding for dialysis treatment of about 170 to 180 people, many of whom are undocumented immigrants, will expire at the end of June. The state Legislature has not appropriated any additional funds for the services. Tom Berning, a lawyer for the institute, requested that U.S. District Court Judge William Browning issue an injunction to extend the free treatments. But Logan Johnston, a lawyer representing AHCCCS, said the agency has received a "clarification" from CMS that regular dialysis treatments received by undocumented immigrants in emergency rooms should not be covered by Medicaid. Johnston on June 13 asked that the case be dismissed (AP/Arizona Republic, 6/14).