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EmailNONIMMIGRANT VISAS FOR MEDICAL TREATMENT
R 192221Z NOV 01
FM SECSTATE WASHDC
TO ALL DIPLOMATIC AND CONSULAR POSTS
SPECIAL EMBASSY PROGRAM
BELGRADE POUCH
DUSHANBE POUCH
LAHORE POUCH
PESHAWAR POUCH
JAKARTA POUCH
SURABAYA POUCH
NASSAU POUCH
NDJAMENA POUCH
UNCLAS STATE 199998
VISAS, INFORM CONSULS
E.O. 12958: N/A
TAGS: CVIS, CMGT
SUBJECT: NONIMMIGRANT VISAS FOR MEDICAL TREATMENT
1. SUMMARY: THIS CABLE ADVISES CONOFFS OF THE POTENTIAL UNINTENDED CONSEQUENCES OF ISSUING VISAS TO FOREIGN NATIONALS SEEKING MEDICAL TREATMENT IN THE UNITED STATES. CONOFFS SHOULD DRAW ON THESE COMMENTS AS THEY REVIEW NIV APPLICATIONS TO ENSURE THAT THE APPLICANTS HAVE OVERCOME PUBLIC CHARGE ISSUES AND FULLY ESTABLISHED THEIR ELIGIBILITY FOR NONIMMIGRANT STATUS. END SUMMARY.
2. VO/F/P RECENTLY MET WITH [A REPRESENTATIVE] OF CHILDRENS NATIONAL MEDICAL CENTER IN WASHINGTON, WHO EXPLAINED THAT THE EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA) REQUIRES HOSPITALS TO RECEIVE AND TREAT PATIENTS WITH EMERGENCY MEDICAL CONDITIONS, REGARDLESS OF THE PATIENTS ABILITY TO PAY OR LACK OF INSURANCE COVERAGE. THE TREATMENT MUST CONTINUE UNTIL THE CONDITION STABILIZES. A PROBLEM ARISES FOR HOSPITALS IN SOME CASES WHEN A U.S. DOCTOR PROVIDES A LETTER TO AN OVERSEAS VISA APPLICANT AGREEING TO SEE THE APPLICANT AT NO COST. AFTER RECEIVING A VISA, THE APPLICANT TRAVELS TO THE U.S. AND MEETS THE DOCTOR, WHO CONDUCTS AN INITIAL DIAGNOSIS AND REFERS THE APPLICANT TO A HOSPITAL, WHICH IS OBLIGATED UNDER EMTALA TO PROVIDE FOLLOW-ON TREATMENT. IN SOME CASES, THE COST OF THE FOLLOW-ON TREATMENT CAN RUN INTO THE HUNDREDS OF THOUSANDS OF DOLLARS, EXHAUSTING FUNDS THAT CHARITIES HAVE RAISED FOR THE TREATMENT OF INDIGENT LOCAL PATIENTS.
3. [THE HOSPITAL REPRESENTATIVE} CITED SEVERAL EXAMPLES, INCLUDING THE CASE OF A YOUNG LEUKEMIA PATIENT WHOSE PARENTS APPLIED FOR A VISA FOR HIM AND PRESENTED A LETTER FROM A MARYLAND DOCTOR AGREEING TO "CARE FOR" THE CHILD. THE CHILD WAS ISSUED A VISA AND TRAVELLED TO THE UNITED STATES, WHERE THE MARYLAND DOCTOR PROMPTLY REFERRED HIM TO CHILDRENS HOSPITAL. THE CHILD'S TREATMENT IS EXPECTED TO COST USD 650,000. THIS FIGURE REPRESENTS NEARLY THE ENTIRE SUM RAISED BY COLUMNIST BOB LEVEY IN THE WASHINGTON POSTS ANNUAL FUND-RAISING CAMPAIGN TO SUPPORT CHARITY CARE AT CHILDRENS HOSPITAL FOR WASHINGTON AREA RESIDENTS. DEPARTMENT HAS RECEIVED SIMILAR REPORTS FROM NEW YORK CITY'S PUBLIC HEALTH SYSTEM. IN A NUMBER OF CASES, TRAVELERS FROM SOME COUNTRIES RECEIVED VISAS FOR TEMPORARY MEDICAL TREATMENT AND INCURRED SIX-FIGURE MEDICAL BILLS AT PUBLIC HOSPITALS.
4. IN LIGHT OF EMTALA REQUIREMENTS, VO ASKS CONOFFS TO BE JUDICIOUS IN GRANTING NONIMMIGRANT VISAS FOR U.S. MEDICAL TREATMENT. PLEASE QUESTION APPLICANTS CLOSELY TO ASCERTAIN WHETHER THEIR MEDICAL CONDITION MAY REQUIRE MORE THAN AN OFFICE VISIT. IF SO, CONOFFS SHOULD PURSUE A LINE OF QUESTIONING TO DETERMINE THE TYPE AND PROVIDER OF FOLLOW-ON TREATMENT THAT WOULD BE NEEDED. IDEALLY, THE SPONSOR HOSPITAL WOULD EXPLAIN IN WRITING UNDER WHAT CIRCUMSTANCES AND AT WHAT COST IT WILL PROVIDE WHATEVER TREATMENT AND HOSPITALIZATION MAY BE REQUIRED FOLLOWING THE ANTICIPATED DIAGNOSIS.
5. DEPARTMENT RECOGNIZES THAT CONOFFS USUALLY LACK THE EXPERTISE TO ASK DETAILLED QUESTIONS REGARDING AN APPLICANTS MEDICAL CONDITION. DEPARTMENT ALSO RECOGNIZES THAT APPLICATIONS FOR MEDICAL VISAS RAISE HUMANITARIAN CONCERNS AND CAN BRING CRITICISM TO OVERSEAS POSTS IF HANDLED USCISENSITIVELY. FOR THESE REASONS, EACH MEDICAL VISA APPLICATION SHOULD BE GIVEN A SYMPATHETIC AND THOROUGH HEARING.
6. DEPARTMENT NONETHELESS ADVISES CONOFFS TO BE ALERT FOR MEDICAL TRAVEL WHICH MIGHT RESULT IN UNEXPECTED HIGH COSTS FOR U.S. HOSPITALS. IF NECESSARY, THE APPLICANTS HOST-COUNTRY DOCTOR MIGHT ADVISE WHETHER THE APPLICANTS CONDITION APPEARS TO REQUIRE SURGERY OR HOSPITALIZATION. IN THOSE CASES WHERE FOLLOW-ON TREATMENT WOULD SEEM LIKELY (WHICH SEEMS PROBABLE FOR ALMOST ALL CASES), APPLICANTS SHOULD BE ENCOURAGED TO LOCATE A CHARITY AND/OR U.S. HOSPITAL WILLING TO SPONSOR ANY AND ALL FOLLOW-ON TREATMENT FOR THE APPLICANT. IN THE ABSENCE OF A SPONSORING HOSPITAL, APPLICANTS SHOULD BE DIRECTED TO REQUEST A COST ESTIMATE FOR FOLLOW-ON TREATMENT FROM THE U.S. HOSPITAL AND PRESENT EVIDENCE OF SUFFICIENT FUNDS TO PAY FOR THE TREATMENT.
POWELL
