Tuesday, April 17, 2012

Governor of Washington State Suspends Policy that Would have Denied Payment for Certain ED Visits made by Medicaid Patients

In February I wrote about Washington State legislators enacting a law that would deny payment for ED visits that were deemed medically unnecessary. This law was set to take effect on April 1st of this year. However, Governor Chris Gregoire of Washington state recently announced that she is suspending this policy and is considering implementing the alternatives that were suggested and discussed in my original blog.

Friday, February 10, 2012

Update on Washington State Health Care Authority Denying Payment for Emergency Services of Medicaid Patients

Earlier this week I wrote about a new law in Washington State that would deny payment for all Emergency Department Visits that the Washington State Health Care Authority (HCA) deems "not medically necessary" in the ER. The Washington Chapter of the American College of Emergency Physicians, the Washington State Medical Association, and the Washington State Hospital Association have joined forces and have created an online petition to stop this. The petition can be found at http://www.thepetitionsite.com/3/stop-denying-payment-of-emergency-services-to-medicaid-patients/

In addition to the petition, they offer suggestions to save health care costs without denying Medicaid payments for Emergency Department visits. Their suggestions include:
  • Reducing ED visits for narcotic-seeking behavior.
  • Increasing access to primary care and reducing ED visits by collaborative use of next-day or same-day visits to primary care.
  • Creating a "Generics First" initiative spearheaded by physicians to voluntarily develop a statewide drug formulary.
  • Instituting an extensive case management program to reduce ED utilization by frequent users.
  • Tracking emergency room visits to reduce ED shopping.
The new rule is set to take effect on April 1st. I will be watching closely for any updates

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