About Section 1011

On December 8, 2003, the President signed into law the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (Pub. L. 108-173) (MMA), Section 1011, Federal Reimbursement of Emergency Health Services Furnished to Undocumented Aliens.

Pursuant to Section 1011 of the act, Congress has mandated that the Secretary of Health and Human Services directly pay hospitals, physicians, and ambulance providers (including Indian Health Service and Indian tribe and tribal organizations) for their otherwise un-reimbursed costs of providing services required by section 1867 of the Social Security Act (EMTALA) and related hospital inpatient, outpatient, and ambulance services furnished to undocumented aliens, aliens paroled into the United States at a United States port of entry for the purpose of receiving such services, and Mexican citizens permitted temporary entry to the United States with a laser visa.

Section 1011 provides $250 million per year for Fiscal Years (FY) 2005-2008 for payments to eligible providers for emergency health services provided to undocumented aliens and other specified aliens. Two-thirds of the funds will be divided among all 50 states and the District of Columbia, based on their relative percentages of undocumented aliens.

One-third will be divided among the six states with the largest number of undocumented alien apprehensions. From the respective state allotments, payments will be made directly to hospitals, certain physicians and ambulance providers for some or all of the costs of providing emergency health care required under Section 1867 and related hospital inpatient, outpatient and ambulance services to eligible individuals. Eligible providers may include an Indian Health Service (IHS) facility, whether operated by the Indian Health Service or by an Indian tribe or tribal organization. A Medicare Critical Access Hospital (CAH) is also a hospital under the statutory definition.