Wednesday, February 8, 2012

Washington State Plans to Deny Medicaid Payments for All Medically Unnecessary Emergency Room Visits

A few months ago I wrote about Washington State limiting ER visits to 3 per year for Medicaid patients.  That rule was overturned in November, but things in Washington have changed drastically.  Under a new rule, Medicaid will no longer pay for any medically unnecessary emergency-room visits, even when patients or parents have reason to believe they're having an emergency. ER services not paid by Medicaid won’t be billed to the patient, but the doctor and the hospital will not receive payment for the services. They report that the point of the rule is to attempt to cut health care costs by deterring patients with non-emergency conditions from going to the ER and going to a primary care facility instead.
The new rule is set to take effect on April 1st of this year.  If this rule takes effect, it will be the most restrictive ER Medicaid program in the country

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