Podcast

Oct 23, 2025

Roetzel HealthLaw HotSpot: ICE is Coming to Health Care: Make Sure Your Practice is Ready

In this episode of the HealthLaw HotSpot, host Ericka Adler is joined by shareholder Christina Kuta to tackle a timely and complex issue: what health care providers should do if ICE agents arrive at their door. The conversation explores recent ICE activity in health care settings, the importance of having a written policy, and how to protect patient privacy while complying with HIPAA regulations. Ericka and Christina share practical advice for staff, discuss legal requirements, and emphasize the need for documentation and legal counsel.

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Transcript

Ericka Adler:
Hi, everyone. Welcome to the HealthLaw HotSpot. I'm Ericka Adler, shareholder and leader of the health care practice at Roetzel & Andress. I'm joined today by shareholder Christina Kuta, who's also part of our health care practice. We're going to be talking about an issue that is occurring nationwide and impacting a lot of practices — immigration enforcement by ICE.

Christina and I have received questions from practices about what they should do if ICE shows up at their door — not necessarily to talk to employees, but to question or access patients. While many hospitals have policies on this, what we’re focusing on today is how medical practices should be dealing with it. We’ve also put together a policy for our clients since this is such a current and frequently asked issue.

So, Christina, let’s start by talking about what’s happening right now with ICE for those who may not be aware.

Christina Kuta:
Right. It’s happening in other parts of the country, but Chicago has been a particular hot spot. That’s where our practice is located, and ICE agents have been seen roaming around the city and suburbs, visiting various neighborhoods and facilities.

They’ve gone to hospitals and private medical clinics — even entering waiting rooms — to locate people they believe should be in ICE custody. This is creating concern for providers not only here but nationally. We have every reason to believe it could expand, so this is a timely issue for all practices.

Ericka Adler:
Exactly. And what we’re seeing online is that ICE often approaches businesses to catch people entering or leaving or, in some cases, conducts raids. So, let’s talk about what happens if you run a medical or dental practice and ICE shows up. What’s your advice to practices facing this situation?

Christina Kuta:
The first thing I’d tell practices is to make sure you have a policy. Your employees should know exactly what to do and who to contact if ICE walks in. Don’t wait until it happens — have a written policy in place that your key employees, such as front desk staff or office managers, are familiar with.

That policy should be reviewed by legal counsel because there are things a practice can and cannot do, and mistakes could create liability. Your policy should include steps like asking for identification, getting badge numbers, and asking for the purpose of the visit — whether ICE has a warrant or subpoena.

If they do, make sure legal counsel reviews it immediately to confirm it’s valid and to understand the scope of their authority. Also, ICE agents should only remain in public areas of the practice. They cannot enter private areas, like exam rooms or staff-only spaces, without a valid warrant.

Another key point: there’s no requirement to share immigration status information with ICE. Except in Texas and Florida — where specific state laws apply — no other state requires that kind of disclosure. Practices should not volunteer any patient information to immigration authorities.

Ericka Adler:
Right. I don’t recall ever being asked about immigration status at a doctor’s office. So even if a practice wanted to provide that information, they likely couldn’t. My concern, though, is that ICE agents may refuse to cooperate — they might not show ID or provide details — and the person in charge of the office might not even be present.

So, while we want to have policies, we also need to prepare staff for real-world scenarios. The key is ensuring safety and making sure staff state the rules clearly. There’s no perfect solution, but I imagine ICE is less likely to press the issue if a practice knows the rules and insists on identification and procedure, right?

Christina Kuta:
Exactly. And it’s important to designate an authorized or backup person who handles these interactions — someone always on site, like an office manager or assistant manager.

Documentation is also critical. Write down everything — names, badge numbers, what was said, what was requested. If possible, have a second witness, like a front desk staff member, who can verify the interaction later. That record will be useful for your legal counsel.

Ericka Adler:
That makes sense. What about if ICE tries to take items or records? Medical offices, of course, handle protected health information.

Christina Kuta:
HIPAA still applies. There’s no HIPAA exception for ICE agents. Patient information — even a name — is protected health information (PHI). The only exceptions are if ICE presents a valid warrant or a judge-issued subpoena for medical records.

If they present documents requesting records, take a copy and tell them you’ll review it with counsel. Don’t hand over information until your attorney confirms it’s valid. And yes — that includes verbal disclosures. Even saying a patient’s name is a HIPAA violation if unauthorized.

Patients themselves, if in the waiting room, are free to speak with agents or to remain silent. The practice should not encourage or compel any disclosure, nor should it give ICE access to check-in sheets or patient lists.

Ericka Adler:
That’s a great point. And before we wrap up, I want to mention — this is a developing area. Our current advice is based on best practices, but as we see how ICE interacts with medical facilities, we’ll continue to update our recommendations.

One final note: if you have employees working in your practice who lack proper documentation, that’s a separate issue from patients. Employers are responsible for ensuring employment eligibility paperwork is properly completed. But today, our focus is on patient-related interactions.

Christina Kuta:
Right. And while some practices might try to handle this internally, it’s important to recognize that this issue touches on multiple areas of law — immigration, civil rights, criminal, employment, and health care. It’s complex, and there are real risks. Having knowledgeable legal counsel help you create and implement a policy is the best approach to avoid problems down the road.

Ericka Adler:
Excellent advice, Christina. Thank you, as always.

This has been the HealthLaw HotSpot. If you have any questions about this topic or any others, feel free to reach out to me or Christina. You can also catch our other episodes at ralaw.com.