Caught in the middle?  What determines emergency care?...treatments that are not an emergency are not covered by either state or federal funds..other states have similar or related actions in the works...how do hospitals and doctors respond?  Is it under used?  I'm not quite sure I understand all of this as well...what part is under used?  BD

The federal government has told New York State health officials that chemotherapy, which had been covered for illegal immigrants under a government-financed program for emergency medical care, does not qualify for coverage. The decision sets the stage for a battle between the state and federal governments over how medical emergencies are defined.

Under a limited provision of Medicaid, the national health program for the poor, the federal government permits emergency coverage for illegal immigrants and other noncitizens. But the Bush administration has been more closely scrutinizing and increasingly denying state claims for federal payment for some emergency services, Medicaid experts said.

Last month, federal officials, concluding an audit that began in 2004 and was not challenged by the state until now, told New York State that they would no longer provide matching funds for chemotherapy under the emergency program. Yesterday, state officials sent a letter to the federal Medicaid agency protesting the change, saying that doctors, not the federal government, should determine when chemotherapy is needed.

Health advocates say that many illegal immigrants who need and qualify for emergency care are afraid to seek help, and that emergency Medicaid is underused.

U.S. Rule Limits Emergency Care for Immigrants - New York Times

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