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Hospitals, AHCA Battle Over Care For Undocumented Immigrants

hospital workers in hospital
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

In what was dubbed an "inevitable sequel" in a long-running legal battle, a state appeals court Tuesday heard arguments in a dispute about Medicaid payments to hospitals that provide emergency care to undocumented immigrants.

More than two dozen hospitals across the southern part of the state and the Tampa Bay region are challenging the Florida Agency for Health Care Administration in the case before the 1st District Court of Appeal. 

Hospitals are required to treat patients who show up for emergency care, but the legal dispute has focused on the extent of care for undocumented immigrants that should be covered through the Medicaid program. Hospitals in 2012 won an administrative case challenging AHCA over a standard for determining the duration of payments.

That ruling prompted the agency to make a change that was again challenged by the hospitals. Administrative Law Judge John D.C. Newton last year upheld the agency's new position, prompting the hospitals to take the dispute to the 1st District Court of Appeal.

Part of the arguments Tuesday focused on direction from the agency that Medicaid would pay for services until emergencies are "alleviated." The hospitals contend the agency's use of alleviation effectively created a new standard that was not approved through a required rule-making process.

Members of a three-judge panel questioned attorneys on both sides about the issue, including what the word alleviate means. "What is the agency's definition of alleviate?" Judge Joseph Lewis asked at one point.

Also, the hospitals contend that the Department of Children and Families, not AHCA, is responsible under law for determining Medicaid eligibility and duration of care. It was not immediately clear when the appeals court will rule.