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Florida hospitals will now ask about your immigration status. What to know, how to answer

The new law does not apply to other healthcare providers, including doctors offices and community health centers
 
Flanked by Jackson Health System President and CEO Carlos Migoya, left, and Miami-Dade County Mayor Carlos Gimenez, Governor Ron DeSantis answers questions during a press conference regarding COVID-19 at Jackson Memorial Hospital in Miami, Florida, on Monday, July 13, 2020. Florida hospitals that accept Medicaid will be required to query patients about that, although a person can decline to answer. The measure is just one of many in a new bill, SB 1718, approved by the Florida Legislature and signed by Gov. Ron DeSantis in May to crack down on the flow of illegal immigration into the state.
Flanked by Jackson Health System President and CEO Carlos Migoya, left, and Miami-Dade County Mayor Carlos Gimenez, Governor Ron DeSantis answers questions during a press conference regarding COVID-19 at Jackson Memorial Hospital in Miami, Florida, on Monday, July 13, 2020. Florida hospitals that accept Medicaid will be required to query patients about that, although a person can decline to answer. The measure is just one of many in a new bill, SB 1718, approved by the Florida Legislature and signed by Gov. Ron DeSantis in May to crack down on the flow of illegal immigration into the state. [ CARL JUSTE|Miami Herald ]
Published July 2, 2023|Updated July 7, 2023

Hospitals ask patients a lot of personal questions. Medical history? Medications? Preexisting conditions? Smoke, drink or do drugs?

As of Saturday, you’ll have one more question to answer: What’s your immigration status?

Florida hospitals that accept Medicaid will be required to query patients about that, although a person can decline to answer. The measure is just one of many in a new bill, SB 1718, approved by the Florida Legislature and signed by Gov. Ron DeSantis in May to crack down on the flow of illegal immigration into the state.

The new law does not apply to other healthcare providers, including doctors offices and community health centers.

Here’s what the new bill will mean for your hospital care:

How will Florida hospitals ask for immigration status?

Hospitals that accept Medicaid will have to include a question on their admission and registration forms asking if a patient is legally in the U.S. or not. The question will be asked to patients who visit the emergency department or are hospitalized.

At Memorial Regional Hospital, one of Broward’s public hospital systems, for example, patients will select from the following options: U.S. Citizen, Legal Resident, Foreign Student, Foreign Visitor, Undocumented, Other/Unknown, Patient declined to answer.

Will your answer affect care? Could you get deported?

The bill states that hospitals will be required to include a statement on the forms notifying patients that their response to the question will not affect their care or result in a report of the patient’s immigration status to immigration authorities. Opponents of the bill have said the immigration question will scare, and stop, some people from seeking care.

The Florida Agency for Health Care Administration, which oversees hospitals in Florida, said in an email to the Miami Herald that it was “in the process of implementing this legislation and will work with hospitals to ensure they have the information they need to comply with the new law before the effective date.” The agency, along with state Sen. Blaise Ingoglia, R-Spring Hill, who sponsored the bill, did not answer the Miami Herald’s questions about the bill.

Which hospitals are affected by the law?

Any Florida hospital that accepts Medicaid will be required to follow the new law. The South Florida hospital list includes:

In Miami-Dade:Jackson Health System, Miami-Dade’s public hospital system; Baptist Health South Florida; University of Miami Health System, also known as UHealth; Mount Sinai Medical Center; HCA Florida Mercy Hospital; HCA Florida Kendall Hospital; Nicklaus Children’s Hospital.

In Broward: Cleveland Clinic Florida; Holy Cross Health and other Archdiocese of Miami hospitals; Broward Health Medical Center and Memorial Regional Hospital, Broward’s two public hospital systems; and Joe DiMaggio Children’s Hospital, which is part of Memorial Healthcare System.

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What if your doctor’s office is in a hospital? What about urgent care and clinics?

The law requires only hospitals to ask patients about their immigration status. The law does not apply to doctors who have their own practice, including those who rent office space on a hospital’s campus, according to the Florida Association of Community Health Centers.

The law doesn’t apply to other healthcare providers, including urgent care centers, community health centers, anti-abortion pregnancy health centers, abortion clinics and retail pharmacies like CVS Health and Walgreens.

What will be done with this information?

Under the new law, Florida hospitals that accept Medicaid will need to submit a quarterly report to the Florida Agency for Health Care Administration, the agency that oversees hospitals in the state. This report must include the number of hospital admissions and emergency department visits the hospital had, along with how many of these visits were made by U.S. citizens or people who are lawfully in the country, undocumented patients and patients who declined to answer, according to the new law.

The agency will then need to submit a similar report every year to the governor, the Senate president and the speaker of the House, along with information on how much it costs to provide healthcare to undocumented patients, including the “impact of uncompensated care on the cost or ability of hospitals to provide services to the public, hospital funding needs, and other related information,” the law states.

The law also gives the agency the authority to adopt rules relating to what information will be in the quarterly reports, and the “acceptable formats for hospitals to use in requesting information” on a patient’s immigration status. The law notes that the “rules may not require the disclosure of patient names or any other personal identifying information to the agency.”

What are South Florida hospitals saying?

Four hospital groups in Miami-Dade and Broward responded:

Jackson Health System said the new law will have “almost no impact” on its services or patients. “We have consistently asked patients to voluntarily disclose their immigration status for both demographic tracking purposes and, in some cases, to help identify sources of financial assistance,” the hospital said in an emailed statement. “The only significant change under this law is that Jackson will be required to report quarterly to regulators the number of undocumented patients we treated and the cost of their care. Nothing in this law would change anything about individual patient’s privacy rights, which strictly protect their personal information. Consistent with our historic mission, we are proud to continue providing high-quality care to every Miami-Dade resident, regardless of their status.”

HCA Florida Healthcare, which has hospitals across the state, including Mercy Hospital in Miami and Kendall Hospital, said its “priority is to provide exceptional and compassionate care to all of our patients” and that “any time the legal, legislative or regulatory landscape changes, our responsibility is to be in compliance with applicable state and federal laws and regulations.”

Memorial Healthcare System said it “continues to care for everyone who seeks medical attention at our facilities. The safety and wellbeing of our patients and staff is our number one priority. In accordance with the new Florida state law, beginning July 1, 2023, patients who are admitted to our hospitals or present to our emergency rooms will be asked about their legal status, and the system will submit all relevant documentation to the Agency of Health Care Administration (ACHA) as stated by the law. As always, we will continue to care for patients and abide by our state and federal laws.”

Broward Health said it will comply with the new law and shall “include a citizenship/immigration status question for all emergency department and hospital patients. ... We will report how patients answer that question, not who answers it, which is also compliant with the law,” the hospital’s statement reads. “As always, we welcome all patients and look forward to continuing to provide care to our community.”