Records obtained by American Oversight show outside medical providers have gone unpaid since October, raising concerns about detainees’ access to lifesaving care.

A breakdown in the federal government’s medical payment system has left outside providers unpaid for treating immigration detainees since October, raising concerns about access to necessary care, according to a Los Angeles Times investigation.

For years, a Department of Veterans Affairs unit processed medical claims for U.S. Immigration and Customs Enforcement and Customs and Border Protection. The VA ended that work Oct. 3, earlier than initially planned, but the private contractors hired to replace it have not begun reimbursing hospitals, clinics, dentists, and pharmacies. ICE has instructed providers to hold their claims while the new system is set up.

Federal records show that ICE itself warned that unpaid providers could stop accepting detainees, delaying dialysis, chemotherapy, prenatal care, and other potentially lifesaving treatment. The agency originally expected claims processing to resume by April 30, but the replacement system was still not operating in early August.

Records obtained by the nonprofit watchdog American Oversight show how heavily federal immigration agencies rely on outside providers. From January through early October 2025, the government processed more than 233,000 claims and paid about $96 million for off-site medical and dental care. ICE accounted for about $77 million of that amount, while Customs and Border Protection accounted for about $19 million.

The treatment included care for cancer, seizures, HIV, pregnancy, serious injuries, mental illness, suicide attempts, and chronic conditions such as diabetes and high blood pressure. The records included 419 claims involving suicide or self-harm and more than 2,200 involving pregnancy, childbirth, or maternal care.

ICE and Customs and Border Protection use roughly 3,000 outside medical providers and generate about 300,000 claims annually, according to the Times. It remains unclear how many claims have accumulated since October, whether any providers have stopped treating detainees, or whether delayed care has contributed to deaths or worsening health conditions.

The payment breakdown comes amid heightened scrutiny of medical care at immigration detention centers, including Delaney Hall in Newark.

Edwin Jovanny Lopez Cornejo died after a medical emergency there Aug. 1. His mother has said she believes he was not receiving medication for diabetes, high blood pressure, and seizures. ICE has maintained that he received appropriate medical attention.

At least 23 people have died in immigration custody so far this year, according to the Times. Two Democratic members of Congress have asked the VA and the Department of Homeland Security to explain when payments will resume and whether the disruption has prevented detainees from receiving outside care. They said the agencies have not answered their questions.