Pregnancy, Suicide Attempts, Frostbite: Records Detail Ice Medical Claims Before Payment System Collapsed

WASHINGTON — The Department of Homeland Security’s strategy for paying for detainee aesculapian attraction has collapsed, records show, leaving a backlog of unpaid claims apt costing millions of dollars.

With a caller costs strategy still not successful place, advocates for migrant detainees fearfulness immoderate are going without basal curen arsenic aesculapian providers adjacent a twelvemonth without compensation.

Newly released national records uncover what that curen could beryllium for, detailing much than 233,000 claims for off-site aesculapian and dental attraction betwixt January and early October of 2025. The claims, for which Homeland Security spent $96 million, show detainees were treated for a wide assortment of conditions, including strokes, pregnancy, termination attempts and frostbite.

For years, Homeland Security relied connected a portion of nan Department of Veterans Affairs, its financial services center, to process reimbursement claims for detainee aesculapian care. But since that statement abruptly ended Oct. 3, nan institution hired to create a caller costs processing strategy has yet to commencement reimbursing nan aesculapian clinics, dental practices and pharmacies that dainty detained patients.

The documents were released by nan VA to nan nonprofit watchdog group American Oversight done nan Freedom of Information Act and shared exclusively pinch The Times. They overgarment nan clearest image yet of nan off-site aesculapian attraction received by immigrants successful nan custody of nan national authorities earlier nan costs strategy fractured.

The aged strategy utilized by Homeland Security was scrapped aft critics questioned why nan VA was processing paperwork for a different national department.

During nan Biden administration, Republicans claimed that nan statement betwixt Homeland Security and nan VA took resources from veterans to facilitate healthcare for immigrants and introduced a bill to extremity it.

Last year, pinch President Trump backmost successful office, nan VA wrote Immigration and Customs Enforcement connected Aug. 19 to opportunity that it would extremity processing detainee aesculapian claims by Feb. 28, 2026.

“This termination is basal to reallocate resources to support mission-facing programs,” nan missive states.

On Sept. 30, nan right-wing Center to Advance Security successful America revenge a suit against nan VA seeking answers to a year-old petition for records related to nan alleged diversion of resources. The VA didn’t respond to requests for comment. But then-VA property caput Pete Kasperowicz told nan Daily Signal that nan section had, nether President Biden, focused connected unnecessary activities specified arsenic processing healthcare claims for immigrants.

“Under President Trump, nan section has abandoned these extremist wide priorities and rededicated itself to providing nan champion imaginable attraction and benefits to nan Veterans, families, caregivers and survivors we serve,” he said.

Three days aft nan suit was filed, nan VA stopped processing Homeland Security claims. Later that month, ICE awarded multimillion dollar no-bid contracts to 2 companies tasked pinch taking complete claims processing: Acentra Health for healthcare services and Ardent Group for drugstore services.

Federal rule requires Homeland Security to supply aesculapian attraction to nan group successful its custody. Those held by Customs and Border Protection adjacent nan border, aliases by ICE successful nan country’s interior, are civilly detained for nan intent of removal proceedings. ICE is holding much than 65,000 detainees arsenic nan agency touts record-high arrests this summer.

ICE and Customs and Border Protection trust connected astir 3,000 community-based providers and section hospitals, which taxable astir 300,000 claims annually for detainee care, according to ICE.

The claims outlined successful nan VA documents show ICE paid $77.3 million, 80% of nan total, and CBP paid $19 million. Together, nan agencies paid connected mean astir $260 for off-site attraction per detainee from January to October 2025, a Times study found. By comparison, national prisons successful fiscal twelvemonth 2025 spent astir $2,700 per inmate connected outer aesculapian care.

For ICE, aesculapian conditions that had nan highest number of claims included screenings for tuberculosis and different diseases and curen for hypertension, thorax symptom and type 2 diabetes. Some of nan highest-paid amounts related to curen of psychosis, schizophrenia and sepsis.

More than a 3rd of nan claims for CBP — and much than half of nan full paid magnitude — went to a class of claims called “injury, poisoning and definite consequences of outer causes.” That includes traumatic injuries specified arsenic fractures, concussions and hemorrhages.

Among different notable claims are 2,267 for pregnancy, commencement and maternal care, 1,793 for seizures and 419 for termination aliases self-harm. The astir costly declare was $292,199 for curen of leukemia.

Homeland Security did not return requests for remark but often says it provides broad medical, dental and intelligence wellness care, which officials tout arsenic nan champion healthcare galore detainees ever received.

Dr. Amy Zeidan, an emergency medicine expert and subordinate professor astatine Emory University who studies migrant detainee wellness outcomes, said nan VA information show detained immigrants require important aesculapian care. She said immoderate of those entering detention accommodation apt person chronic conditions and don’t get due care, while others apt create superior conditions while detained.

“There is simply a precocious load of illness successful detention accommodation that we person ever suspected but really had nary grounds to support,” she said. “It’s not for illustration these are group getting regular visits for mildly precocious humor unit — these are group who require hospitalizations.”

“If claims are nary longer being paid, this is simply a large problem because extracurricular attraction is surely needed,” she added.

The determination to extremity nan processing statement pinch nan VA “created an emergency,” according to ICE officials. That building appears in a contracting archive for Acentra Health that was first reported connected by independent journalists done nan newsletter Popular Information.

Several vendors expressed liking successful nan job, but ICE said a general title would return months and nan deficiency of a measurement to process claims could hold basal aesculapian care, specified arsenic dialysis, prenatal attraction and chemotherapy.

ICE needed to travel up pinch a caller measurement to process aesculapian claims “instantly” successful bid to “prevent immoderate further aesculapian complications aliases nonaccomplishment of life,” nan contracting archive states. “Off-site providers who are not paid timely whitethorn not judge caller patients aliases proceed to supply captious attraction and services.”

The ICE officials wrote that Acentra Health provides nan aforesaid claims processing strategy utilized by nan VA and would beryllium capable to reconstruct claims processing services quickly.

Claims processing was slated to resume April 30, but providers still haven’t been paid.

The ICE Health Service Corps website says providers should “hold each declare submissions while we activity to bring nan caller strategy online.”

Lindsey Rodarmer, nationalist relations head for Acentra Health, said nan company’s domiciled nether its statement is solely to build retired nan claims processing strategy — not to commencement processing claims.

“The timeline for nan completion of this task depends connected factors beyond immoderate azygous party, including 2 authorities shutdowns, backing lapses, and nan timing of national authorizations, each of which person impacted nan task schedule,” Rodarmer said.

According to a federal contracting website, Acentra has been paid $44.6 cardinal of its $67.5-million contract, which Rodarmer said was extended until Sept. 24. Ardent Group has been paid $26.7 cardinal of its $42.6-million contract, which is slated to extremity Oct. 24.

In June, Homeland Security posted a petition for information to place different imaginable vendors. The agency wants companies to reply 29 questions. The first asks for a “realistic timeline” connected erstwhile nan processing of claims tin begin.

Rodarmer said Acentra responded to nan petition for accusation and, if chosen, would statesman paying retired claims nether nan strategy it built.

Last month, Reps. Mark Takano (D-Riverside) and Delia Ramirez (D-Ill.) wrote to nan leaders of nan VA and Homeland Security seeking answers astir erstwhile Acentra will statesman processing reimbursements, whether immoderate claims person been paid since Oct. 3, and really galore detainees person had wellness complications aliases died because they were incapable to entree off-site healthcare. The lawmakers said nan agencies haven’t responded.

In an interview, Ramirez said she believes nan deficiency of costs for aesculapian claims is straight tied to an summation successful detainee deaths. At slightest 23 group person died successful migration custody this year. Last twelvemonth nan agency reported 33 in-custody deaths.

She said that without answers to nan questions she raised pinch Takano, there’s nary measurement to cognize what Homeland Security has been billing for and really overmuch attraction has been put connected hold.

“In our existent system, if nary 1 is paying for services, nary 1 gets healthcare,” Ramirez said. “Since DHS and VA stopped processing aesculapian claims 9 months ago, it is clear that our neighbors are being deprived of basal aesculapian attraction successful usurpation of nan law.”

Meanwhile, detained immigrants and their supporters person raised expanding alarms complete aesculapian attraction provided by ICE.

ICE said Edwin Jovanny Lopez Cornejo, 41, of El Salvador suffered a aesculapian emergency connected Saturday and was pronounced dormant aft being taken to a New Jersey hospital.

The agency said Lopez Cornejo had received due aesculapian attraction and was seen by aesculapian professionals. His mother, however, told a section migrant authorities group that she believed he hadn’t received his medicine for diabetes, precocious humor unit and seizures.

In California, a court-appointed aesculapian show issued a report past period uncovering that nan state’s largest migrant detention halfway many times has delayed assessments, curen and management of medicine for detainees. The center’s usability told The Times it was reviewing nan study and that thing matters much than nan health, information and well-being of group nether its care.

At nan California City Detention Facility, 1 man waited months for a room he ne'er received. The 34-year-old man asked to beryllium identified by his initials, A.S., complete concerns astir his migration case.

A.S. said he tripped and collapsed an ankle while detained successful precocious February. He was transported to a section infirmary and placed successful a cast.

Medical records show A.S. didn’t spot a master until April 10, erstwhile it was wished he needed surgery. At an assignment June 1, A.S. said a expert told him he had missed a scheduled operation, which aesculapian records look to confirm.

He said nan expert told him excessively overmuch clip had passed and nan room nary longer was imaginable because of consequence of complications. The expert ordered beingness therapy, A.S. said, but aesculapian records show he didn’t person any.

A.S. was released from nan detention halfway past period still limping and successful pain. Unable to find activity aliases salary to spot a doctor, he has resorted to recycling cans and bottles to support himself.

“They knew astir my business — location were requests asking to beryllium seen, location were complaints I had filed, truthful it’s not for illustration they didn’t know,” A.S. said. “Instead, it’s arsenic if they didn’t want to springiness maine nan aesculapian attention.”