Can I add the amount of my 2023 state tax refund to my total medical expenses paid if that refund amount was seized by the hospital for outstanding medical bills?

Yes, you can use the state tax refund as long as it was paid/withheld to pay the medical expenses in 2024. Include this with your other medical expenses on itemized deductions for your federal return. 

Keep in mind that only the amount that is in excess of 7.5% of your adjusted gross income (AGI) will be used as medical expenses on Schedule A (itemized deductions).