II 

118TH CONGRESS 

2D SESSION S. 5248 

To require hospitals participating in Medicaid or the Children’s Health Insurance Program to inquire whether a patient is a citizen or national 

of the United States, or in a satisfactory immigration status, as part 

of the patient admission and registration process, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 25, 2024 

Mr. LEE (for himself, Mr. SCHMITT, and Mr. BRAUN) introduced the following 

bill; which was read twice and referred to the Committee on Finance 

A BILL 

To require hospitals participating in Medicaid or the Children’s Health Insurance Program to inquire whether a 

patient is a citizen or national of the United States, 

or in a satisfactory immigration status, as part of the 

patient admission and registration process, and for other 

purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Citizenship 

5 Verification in Emergency Healthcare Act’’. 


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•S 5248 IS

1 SEC. 2. REQUIRING HOSPITALS TO INQUIRE WHETHER A 

2 PATIENT IS A CITIZEN OR NATIONAL OF THE 

3 UNITED STATES, OR IN A SATISFACTORY IM4 MIGRATION STATUS, AS A CONDITION FOR 

5 PARTICIPATION IN MEDICAID AND THE CHIL6 DREN’S HEALTH INSURANCE PROGRAM. 

7 (a) IN GENERAL.—Section 1902(kk) of the Social Se8 curity Act (42 U.S.C. 1396a(kk)) is amended— 

9 (1) by redesignating paragraph (9) as para10 graph (10); and 

11 (2) by inserting after paragraph (8), the fol12 lowing new paragraph: 

13 ‘‘(9) REQUIREMENT FOR HOSPITALS.— 

14 ‘‘(A) IN GENERAL.—The State requires as 

15 a condition for a hospital to be enrolled under 

16 the State plan or under a waiver of the plan as 

17 a participating provider that the hospital agree 

18 to— 

19 ‘‘(i) as part of the hospital’s patient 

20 admission and registration process— 

21 ‘‘(I) include on the hospital’s pa22 tient admission and registration 

23 forms, a written provision requiring a 

24 patient or the patient’s representative 

25 to state or indicate whether the pa26 tient is a citizen or national of the 


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•S 5248 IS

1 United States, and, if that individual 

2 is not a citizen or national of the 

3 United States, whether the individual 

4 is in a satisfactory immigration sta5 tus; and 

6 ‘‘(II) provide the patient or the 

7 patient’s representative with a written 

8 statement that the response to the 

9 provision required by clause (i) shall 

10 not affect patient care or result in a 

11 report of the patient’s immigration 

12 status to immigration authorities; and 

13 ‘‘(ii) annually report to the Sec14 retary— 

15 ‘‘(I) the total dollar amount of 

16 uncompensated care furnished by the 

17 hospital to— 

18 ‘‘(aa) all individuals who are 

19 not citizens or nationals of the 

20 United States; and 

21 ‘‘(bb) all individuals de22 scribed in item (aa) who are not 

23 lawfully residing in the United 

24 States; and 


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•S 5248 IS

1 ‘‘(II) the total amount of funds 

2 received by the hospital under the 

3 State plan or under a waiver of such 

4 plan for providing medical assistance 

5 for— 

6 ‘‘(aa) the delivery of a child 

7 whose parents are not citizens or 

8 nationals of the United States 

9 but are lawfully residing in the 

10 United States; and 

11 ‘‘(bb) the emergency delivery 

12 of a child whose parents are not 

13 lawfully residing in the United 

14 States pursuant to section 

15 1903(v). 

16 ‘‘(B) REPORT TO CONGRESS.—The Sec17 retary annually shall submit a report to Con18 gress that includes the most recent information 

19 reported to the Secretary by hospitals under 

20 subparagraph (A)(ii).’’. 

21 (b) LIMITATION ON FEDERAL FINANCIAL PARTICI22 PATION.—Paragraph (2) of the first sentence of section 

23 1903(i) of the Social Security Act (42 U.S.C. 1396b(i)) 

24 is amended— 


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•S 5248 IS

1 (1) in subparagraph (D), by striking ‘‘or’’ after 

2 the semicolon; and 

3 (2) by inserting after subparagraph (E) the fol4 lowing new subparagraph: 

5 ‘‘(F) with respect to any amount expended 

6 for such an item or service furnished during 

7 calendar quarters beginning on or after the 

8 date of enactment of this subparagraph, by a 

9 hospital that does not comply with the partici10 pating provider conditions required by section 

11 1902(kk)(9)(A); or’’. 

12 (c) RULE OF CONSTRUCTION.—Nothing in this Act 

13 or the amendments made by this Act shall be construed 

14 as preventing a hospital or hospital employee from report15 ing any patient to law enforcement, regardless of citizen16 ship or immigration status, for any suspected criminal ac17 tivity or waiving the hospital’s or hospital employee’s duty 

18 to report under Federal or State law. 

Æ 


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