While we've often discussed the (so-called) Doc Fix, Medicaid is also facing severe budgetary problems. To address these, legislators in the Evergreen State recently passed a bill that would cut off coverage for non-emergency ER visits:
"Starting April 1, Medicaid will no longer pay for [unneeded ER] visits, even when patients or parents have reason to believe they're having an emergency."
On the one hand, this seems fairly drastic, but on the other, the ER should be for, well, emergencies. The tension here is, of course, how is a lay-person supposed to know the difference between, say, a panic attack and a heart attack?
The WSJ has more:
UPDATE/ADDENDUM: In the comments, FoIB NotWithStanding makes a VERY good point:
"Emergency departments are barred from federal law from turning people away without stabilizing them ... The Washington Medicaid plan would simply not pay the emergency providers for care rendered during "unneeded" ED visits, doing nothing to penalize people for coming in unnecessarily"
The reason they're forbidden from turning folks away is a little something the Feds call EMTALA, or the Emergency Medical Treatment and Active Labor Act. As NWS points out, this becomes a damned-if-you-do/damned-if-you-don't scenario for the provider.
But hey, health care's free, right?
"Starting April 1, Medicaid will no longer pay for [unneeded ER] visits, even when patients or parents have reason to believe they're having an emergency."
On the one hand, this seems fairly drastic, but on the other, the ER should be for, well, emergencies. The tension here is, of course, how is a lay-person supposed to know the difference between, say, a panic attack and a heart attack?
The WSJ has more:
UPDATE/ADDENDUM: In the comments, FoIB NotWithStanding makes a VERY good point:
"Emergency departments are barred from federal law from turning people away without stabilizing them ... The Washington Medicaid plan would simply not pay the emergency providers for care rendered during "unneeded" ED visits, doing nothing to penalize people for coming in unnecessarily"
The reason they're forbidden from turning folks away is a little something the Feds call EMTALA, or the Emergency Medical Treatment and Active Labor Act. As NWS points out, this becomes a damned-if-you-do/damned-if-you-don't scenario for the provider.
But hey, health care's free, right?
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