Alleged Internal Memo Reveals ICE Restricted Hospital Visits in What Advocates Label a Cruel 'Death Policy'

An alleged internal memo from Immigration and Customs Enforcement (ICE), according to reports, appears to direct staff to sharply limit off‑site hospital visits for detainees after a breakdown in payments to outside medical providers, prompting civil rights advocates to denounce what they call a cruel 'death policy.'

The controversial operational directives reportedly surfaced following a critical administrative breakdown after the Department of Veterans Affairs abruptly terminated, on 3 October 2025, a long-standing two-decade arrangement to process medical reimbursement claims for detained individuals.

Government contracting filings indicate that the abrupt transition left the federal agency without a functioning payment system for third-party medical providers, including hospitals, ambulance networks, and retail pharmacies.

Consequently, facilities were instructed to treat outside transfers as emergency-only operations, leading to documented delays in essential oncology treatments, cancer surgeries, and seizure management.

While Department of Homeland Security representatives have firmly disputed characterisations of neglect and maintained that detainees retain continuous access to necessary medical evaluations, Congressional lawmakers have demanded immediate federal investigations into rising health complications and disputed billing practices.

The unfolding controversy highlights severe administrative vulnerabilities within federal detention infrastructure and exposes vulnerable populations to critical health risks.

How an Alleged ICE Memo on Hospital Visits Shaped 'Death Policy' Claims

In the wake of the VA split, an internal ICE directive obtained by the San Francisco Chronicle instructed detention staff to treat the situation as 'emergency operations,' limiting off‑site care to emergencies and telling facilities to transport detainees to hospitals in agency vehicles, reportedly out of concern that ambulance companies might refuse uncompensated calls.

The memo, dated shortly after 3 October 2025, also set limits on how many days' worth of medication should be given when detainees were transferred, released or deported.

One redacted medical chart cited in news reports recorded, 'Effective 10/3/2025, Per ICE directive from Commander Persac, the only service authorised at this time is emergency care via the ER.' In separate government documents posted on SAM.gov, ICE described the payment breakdown as an 'absolute emergency' that could delay 'critical prescriptions and life‑saving medications' and warned of potential 'medical complications or loss of life.'

To replace the VA, ICE awarded what contracting records describe as no‑bid contracts in late October 2025: $67.5 million to Acentra Health for medical claims processing and $21.3 million to Ardent Group for pharmacy support.

By August 2026, those records indicated that Acentra had been paid tens of millions of dollars while the new system was still not fully operational and some outside providers had not been reimbursed for services provided since October 2025.

According to reports, investigative journalists identified and documented at least eight detainees whose care was delayed or denied in ways that independent physicians said endangered their health, including a Los Angeles man with recurring throat cancer who waited months for an oncology referral and an asylum seeker whose seizures went unmanaged after medication lapses linked to his brain tumour.

Those reports also describe hospitals billing detainees directly, even though ICE standards state that detainees should receive necessary medical treatment without charge, with documented bills including a $634 blood test and a $17,210 charge for emergency gallbladder surgery on a detainee handcuffed to his bed.

Advocates Call Alleged ICE Hospital‑Visit Restrictions a 'Death Policy'

Advocacy groups have taken to calling the situation a 'death policy,' contending that the reported halt in payments and the triage memo reflect deliberate neglect rather than an administrative glitch. Adina Applebaum of the Amica Centre for Immigrant Rights told reporters that the lack of care reflects 'a deliberate policy choice, not an accident.'

A Department of Homeland Security spokesperson disputed that characterisation, saying detainees retain access to on‑site care, emergency treatment and off‑site speciality referrals, and that scheduling delays are common and outside the agency's control.

Legal experts, including UC Berkeley law dean Erwin Chemerinsky, have been quoted as saying that federal law requires the government to cover medical costs for people in its custody and that direct billing of detainees is unconstitutional.

Two House Democrats, Reps Delia Ramirez (D‑Ill.) and Mark Takano (D‑Calif.), have asked Homeland Security to investigate the lapse, citing what they described as a rise in detainee deaths and health complications.

A former ICE official told reporters that oversight of what they termed improper billing has weakened since staff cuts to the agency's civil rights office, calling the issues a 'systemwide problem.'

IBTimes UK has not independently verified the alleged internal ICE memo or the specific incidents described above.

As legal challenges mount and independent verification remains pending, the controversy underscores deep systemic vulnerabilities in immigration custody management.