The U.S. Immigration and Customs Enforcement (ICE) is a federal agency within the U.S. Department of Homeland Security that enforces immigration policies and removes individuals who are unlawfully present in the United States. Recently, physicians have been observing an increased number of ICE agents who are presenting to hospitals and other medical facilities requesting access to the facilities to carry out their responsibilities. This increased presence has created some concerns about understanding a medical office or facility’s rights and obligations and protecting confidentiality when encountering ICE agents at the medical office/facility.

Below are some frequently asked questions that may be important for physicians and other medical staff to know about the current status of U.S. immigration enforcement and what to do if an ICE agent visits a medical facility or office.

Can ICE agents enter a medical office or facility?

Yes, but their access is subject to certain limitations. On January 20, 2025, President Trump’s administration rescinded a longstanding ICE policy which limited ICE enforcement actions at “sensitive locations” such as schools, medical facilities, and religious institutions. As a result, it is possible that more medical offices and facilities may potentially encounter ICE agents at their office/facility.

Regardless, ICE agents are permitted to enter public areas of a medical office or facility without a warrant. Examples of public areas include waiting rooms, lobbies, parking lots, and any other places that are generally open to the public. However, as further discussed below, ICE agents cannot access private or non-public areas, such as break rooms, exam rooms, offices, or other areas not accessible to the public without a valid judicial warrant.

What do I do if an ICE agent appears at my medical office or facility?

If your medical office or facility has a law enforcement policy, you should follow the process set forth in that policy. For example, a policy may designate a certain person who will be responsible for interacting with the ICE agent.

If your medical office or facility does not have a policy, you should immediately contact legal counsel and follow any initial instructions. Verify the person’s identity and confirm that the person is an ICE agent or other law enforcement. This can be done by asking for identification, such as the person’s business card, badge, or obtaining the person’s name and title. Be aware that ICE agents generally wear uniforms. If there are patients or other staff present, ask the agent to step into an area away from others. 

Do I have to cooperate with an ICE agent?

It depends on what document(s) the agent has in his or her possession. Once you have confirmed the person is an ICE agent, ask the agent about the purpose of his or her visit and whether the agent has any legal documents. If the ICE agents provides legal documents, the documents should be reviewed by legal counsel to determine what compliance, if any, is required by the office/facility. The ICE agent may be asked to wait while the documents are reviewed.

Under federal law, you cannot hide evidence, conceal individuals who are the targets of law enforcement, or otherwise interfere with an arrest. In addition, it is important to keep in mind that ICE agents can look at anything that is in “plain-view.” This includes computer screens or papers they can see in public areas. They can also use any information they overhear.

What documents might an ICE agent have?

An ICE agent might bring with him or her a judicial warrant, administrative warrant, subpoena or immigration detainer.

• A judicial warrant is an official order signed by a judge or magistrate judge that authorizes an ICE agent to enter and search an area of private property. Importantly, an ICE agent is not entitled to enter non-public areas of the medical office or facility without a judicial warrant. You must comply with a judicial warrant.
• An administrative warrant is generally signed by an ICE official, not a judge, and permits the ICE agent to make an arrest or seizure. An administrative warrant does not authorize an ICE agent to engage in a search of nonpublic areas. You are not required to comply with search requests via an administrative warrant.
• A subpoena is a written order used to obtain records, such as medical records, or compel someone to appear and testify in court. Similar to warrants, there are judicial subpoenas, signed by a judge, and administrative subpoenas, signed by a government official. You do not have to immediately comply with an administrative subpoena unless a separate judicial court order requires compliance with the subpoena. You must comply with a judicial subpoena (but it could be challenged in court).
• An immigration detainer is a request from ICE to other law enforcement agencies to hold a non-citizen for up to 48 hours. You do not have to comply with an immigration detainer.

When presented with a document by an ICE agent, it is important to have legal counsel or someone with the proper expertise review the document to confirm your obligation to comply before moving forward with the agent’s request.

What if the ICE agent (or document) requests medical records or other protected health information (PHI)?

HIPAA permits disclosure of medical records and other PHI to law enforcement only under certain specified circumstances. You are not required to disclose PHI (or any other information) if the agent does not have the proper subpoena or warrant authorizing a search or disclosure of such records and information. This includes verbal questions by an ICE agent, such as whether a certain individual is a patient of the office/facility and/or a patient’s immigration status (if such information is maintained in the patient’s medical record).

Is there anything else I should do when interacting with ICE?

At all times, stay calm. Be sure to document the entire interaction, including the agent’s name and badge number. If the agent provides documents that authorize the agent to arrest someone or conduct a search, you should not interfere, but you should observe the interaction to make sure the agent complies with the warrant. Once the agent leaves, document the interaction in writing.

Are there other best practices for interacting with ICE or other law enforcement officials?

Many hospitals and facilities already have policies in place for interactions with law enforcement. Physicians that are employed at hospitals and facilities should familiarize themselves with these policies and comply with the protocols set forth in the policies if confronted by an ICE agent. 

If your medical office or facility does not have a policy, consider preparing a written policy that addresses interactions with law enforcement. The policy should specifically identify the areas of the office or facility that are “private” and the areas that are “public.” The policy should also designate an individual or individuals (such as legal counsel, a physician or office manager) who will be responsible for interacting with law enforcement and/or who can serve as the point of contact for personnel and legal counsel, even when not on-site at the office or facility. These individuals should be familiar with the office/facility’s rights and responsibilities related to immigration and other law enforcement. Consider providing training to staff on the office/facility’s law enforcement policy and what to do if an ICE agent or other law enforcement appears at the office/facility. Finally, be sure to consult with experienced legal counsel to review your policies and protocols to ensure compliance.

This publication was prepared by Kathleen A. Westfall, Esq. and Shavonne M. Gilkey, Esq., Kerr, Russell and Weber, PLC, MSMS Legal Counsel, and is furnished for informational purposes only.  It does not communicate legal advice by the Michigan State Medical Society or Kerr, Russell and Weber, PLC.  Receipt of this publication does not establish an attorney/client relationship.   © 2025 Kerr, Russell and Weber, PLC