The state’s health care program for the poor has agreed to pay for dialysis for about 250 legal and illegal immigrants.
In a settlementannounced Monday, the Arizona Health Care Cost Containment System will now consider it an emergency to provide dialysis for patients with end-stage renal disease, regardless of their citizenship status.
The agreement caps a fiveyear court battle that started after AHCCCS denied coverage to people who could not prove they were legal U.S. residents.
A federal judge later barred AHCCCS from such restrictions when attorneys for the William E. Morris Institute for Justice sued on behalf of dialysis patients who were denied coverage.
Now those patients will continue to have insurance coverage if they meet the income requirements.
“This settlement will save lives,” said Ellen Katz, an attorney for the institute.
Federal regulations became part of the fight because the U.S. government picks up about two-thirds of the cost of AHCCCS.
To be eligible, a person must be a U.S. citizen or have been a legal resident for at least five years, with income at or below the federal poverty level — $20,650 for a family of four.
Those eligibility rules, however, do not apply for emergency care: Anyone whose income is below the federal poverty level qualifies.
In 2001, though, the federal government concluded that dialysis does not constitute emergency care. That resulted in AHCCCS trying to cease treatment.
This settlement requires AHCCCS to amend its rules and to notify doctors, clinics and hospitals that all patients with end-stage renal failure qualify for government health care coverage.
Katz said that includes people whose health could be seriously jeopardized in the absence of dialysis. She said that at any given time there are about 250 people who will be affected by the settlement.
AHCCCS spokeswoman Rainey Holloway estimated the annual cost at close to $5.2 million.