Treating Illegal Immigrants

Question: What are the legal obligations for physicians treating illegal immigrants? Must they see patients that have no documentation at all? What if patients present themselves at the physicians’ office with no documents, speaking limited English, and without the ability to pay for the service? What if the doctor saw such a patient for an initial appointment and does not wish to conduct subsequent appointments?

Answer: First of all, there are state laws. You’ll need to know what applies in your state. However, here are general guidelines provided anonymously by an attorney:

There is no specific requirement to treat or not treat someone based on immigration status. One thing to note is that a physician cannot, in most circumstances, report someone to the federal government or any other authority without violating patient confidentiality.

Physicians are not obligated to see all patients who present themselves. However, immigration “documentation” and the ability (or inability) to speak English are non-issues. Physicians are not obligated to provide uncompensated care in their offices. The federal Emergency Medical Treatment and Active Labor Act (EMTALA) imposes different obligations if the patient is seen through a hospital emergency department. Note that EMTALA has been interpreted by some to require physicians to provide necessary follow up care.

There are no hard rules about discontinuing service to a patient. Common practice is to adopt the AMA guidelines, which suggest that patients be notified of the termination of the physician-client relationship and given 30 days to find another physician. During that period of time, the initial physician should provide required ongoing care and any emergency care that is related to the same illness or condition that initially brought the patient to the physician.