Hospitals that give emergency care to undocumented migrants will get $1 billion in federal dollars, which means providers like Jackson could recoup losses.

 BY DAVID OVALLE

  A little-publicized provision in the Medicare bill passed late last year will make about $1 billion available to hospitals, such as Jackson Memorial Hospital,
  that provide emergency care to undocumented immigrants.

  The money would chip away at the growing amount of so-called ''charity care'' that many hospitals say poses a serious financial burden. In 2001, the last
  year for which figures were available, Jackson Memorial spent $37 million to treat about 6,600 uninsured and undocumented patients.

  Nationally, some estimates by healthcare analysts place the total amount hospitals pay to treat undocumented people who cannot pay their medical bills at
  about $2 billion. Florida ranks behind California, Texas and Arizona in the amount its hospitals spend on care for undocumented patients.

  Much of the new federal money, which will be allocated over four years, will be given directly to hospitals in states that have the highest numbers of
  undocumented migrants. The Department of Health and Human Services, which administers Medicare and Medicaid, must still hammer out a formula to
  decide how much to give to individual hospitals that qualify for the money.

  Officials said they could not provide an estimate of how much money Florida hospitals would receive.

  Federal officials said they hope to have an application ready by September for funds that will become available starting next year.

  A TENSE ISSUE

  The issue of providing healthcare to illegal immigrants has become an intensifying source of controversy as the cost of healthcare has continued to soar.
  The General Accounting Office is expected later this year to release a report that will examine the issue of hospitals paying to treat undocumented
  immigrants.

  ''We're very interested in any program that is going to help us offset losses. We will certainly be looking at aggressively pursuing the money,'' said
  Conchita Ruíz-Topinka, a spokeswoman for Jackson. ``We're not going to step away from the commitment to the community.''

  A study released last year by the Florida Hospital Association found that in 2002, hospitals in the state spent at least $40.2 million to treat 705 uninsured
  foreign nationals.

  GUARANTEE OF CARE

  By law, hospitals cannot turn away patients who show up in their emergency rooms or ask them about their immigration status.

  At Jackson, one of the busiest public hospitals in the country, hospital administrators ask patients only to prove that they live in Miami-Dade County.

  Jackson's charity care is funded mostly by taxpayer dollars and fees collected from publicly or privately insured patients.

  Other Florida hospitals have racked up considerable bills -- and headlines -- for their medical treatment of undocumented migrants.

  Earlier this year, Martin Memorial Medical Center in Stuart was criticized for returning an uninsured, undocumented patient to his native Guatemala after he
  racked up $2 million in care over more than three years.

  Hospital spokeswoman Lisa McCluskey said that the hospital would analyze the Medicare bill's provision for reimbursement. ''It's too early to say if we're
  going to apply,'' she said.

  CARRYING THE BURDEN

  U.S. Rep. Mark Foley, a Republican from Palm Beach County who pushed for the GAO study, said that compensating Florida is the right thing to do because
  the government has not done enough to prevent illegal immigrants from entering the state.

  ''It's a good first step. The burden that falls on these local hospitals has been extraordinary,'' Foley said.