The New York Times reported to day that a number of illegal immigrants who were receiving free care at at Grady Memorial Hospital in Atlanta had become a bone of contention between Grady and a Fresenius Medical Care Dialysis Clinic there, with Frensius foregoing further treatment and advising patients to wait until they were in serious condition in order to force Grady’s emergency room to take them under EMTALA.
Several years ago Grady, a public hospital loosing money, shut down its ambulatory dialysis clinic. It had about 60 insured immigrant patients at the time. Grady offered to pay for transportation of its patients back to their home countries or to other states and to pay for 3 months of care. Some took the offer, some didn’t. Grady then contracted with Fresenius for a year to treat some of the remaining patients in transition. When the contract expired, Grady signed up for one additional year which expired in August. Grady spent 2 million dollars on the immigrants after closing its clinic. Grady is allegedly facing a 20 million dollar shortfall this year. It was unable to negotiate a second extension of the contract with Fresenius.
There is an interesting question as to who has the risk here. After 2 years of service can Fresenius just wash its hands of responsibility? What are the obligations of Grady to continue the subsidy in light of its financial condition? Is there any obligation to treat them if they are illegal aliens and cannot pay? If all the remaining patients wait until they are in serious impairment, there just may be a lawsuit to sort out these questions.