Arizona Supreme Court Extends Medicaid Emergency Care Coverage for Undocumented Immigrants

The Arizona Supreme Court on Aug. 21 ruled that the Arizona Health Care Cost Containment System, the state's Medicaid program, must continue to cover the cost of emergency care for undocumented immigrants after hospitals transfer them from acute-care units, the AP/Arizona Republic reports. The case involved interpretations of a state law that makes undocumented immigrants eligible for AHCCCS coverage in cases of emergency and a federal law that the state uses to define emergency conditions. The court ruled that the definition must focus on the current condition of patients and "whether the person has acute symptoms caused by an emergency medical condition that arose rapidly and not over time," the AP/Republic reports. In the decision, Justice Michael Ryan wrote that "even though an initial injury may be stabilized, that does not necessarily mean the emergency has ended." The Aug. 21 decision overturns several lower court decisions that said AHCCCS did not have to cover the cost of care for five undocumented immigrants at Scottsdale Healthcare Osborn and Banner Good Samaritan Medical Center. The companies that manage the hospitals filed the lawsuits to force AHCCCS to cover the cost. In the cases, attorneys for AHCCCS argued that the program did not have to cover the cost of care after the hospitals transferred the patients from acute-care units because their emergency conditions had ended. The state Supreme Court returned the cases to the state Court of Appeals for additional consideration based on the standard established in the Aug. 21 decision.

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Cameron Artigue, an attorney for the hospitals, said, "We certainly regard this as a win. There will be further proceedings in the lower court, but we are confident when you compare the medical conditions of the patients with the standards established by the court that the hospitals will prevail." Frank Lopez, a spokesperson for the AHCCCS, said, "The Supreme Court has given us direction. It's not necessarily the direction we would have preferred. We will go back to trial court and decide what to do on the broader implications" of the decision. According to Lopez, AHCCCS spends between $75 million and $80 million per year to cover the cost of emergency care for about 200 to 300 undocumented immigrants each month; the state covers about one-third of the total cost, he said (Davenport, AP/Arizona Republic, 8/22).