Prisoner Health Care

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Prisoner Health Care Standards

The prisoner health care standards described in these web pages provide U.S. Marshals guidance. They are not intended to, do not, and may not be relied upon to create any rights, substantive or procedural, enforceable at law by any party or person in any matter civil or criminal. Nor are any limitations hereby placed on otherwise lawful prisoner care prerogatives of the U.S. Marshals Service.

The Marshals Service relies on state and local jails as well as Bureau of Prisons detention facilities to provide medical care inside the facilities. However, the Marshals Service is responsible for providing a secure escort and for paying for care when a prisoner must go to medical facilities in the local community. (See USMS Prisoner Health Care Standards.)

The Marshals Service faces an increasing number of prisoners suffering from extremely complex medical problems, such as cancer, terminal AIDS, and liver and kidney failure. The Marshals Service is increasingly concerned with protecting its staff, other prisoners and the general public from exposure to infectious diseases such as active tuberculosis. These cases present a distinct challenge to the already limited agency personnel resources.

The Marshals Service has also begun to implement medical cost containment initiatives by establishing: preferred provider medical networks; centralized medical bill review and pricing; locked hospital wards in local facilities; and interagency cooperative efforts with the U.S. Public Health Service and the department of Veterans Affairs. During the past ten years, the Marshals Service has reduced its prisoner medical care costs by $171.6 million through innovative cost-saving projects. Additionally, Congress now authorizes the Marshals Service to apply Medicare rates for prisoner medical bills, and this new initiative will save the agency a significant amount of money each year.