States fight Medicaid cuts to emergency care

In a battle to keep Medicaid funds, states including Washington, Iowa, and Tennessee are fighting for continued reimbursements for emergency care. Under recent Medicaid managed care quality initiatives, hospitals will receive lower reimbursements for conditions that are deemed non-emergent, reports American Medical News. Particularly controversial though is what is considered "non-emergent."

"I don't think that people misuse the ER," said Dr. Malika Fair, an emergency physician at Prince Georges Hospital in Cheverly, Md. "Everyone thinks they have an emergency."

In Washington, the American College of Emergency Physicians (ACEP) last month filed suit to reverse the state's decision to limit emergency visits. Washington starting on Oct. 1 implemented an annual limit of up to three visits per Medicaid beneficiary for 700 non-emergent conditions, including chest pain, abdominal pain, miscarriage, and breathing problems, according to a Sept. 30 ACEP press release. The ACEP agreed to 200 conditions but then denied the final list, arguing that it put patients at risk, according to the article.

Similarly, Tennessee starting in July stopped Medicaid reimbursements for 51 non-emergent cases as part of a budget reduction plan. In Iowa starting in September, the state began a tiered payment system in which Medicaid fees were also cut to 75 percent, according to the article.

Although patient advocates and professional physician organizations are decrying the changes, state agencies are aiming to curb healthcare spending.  

Dr. Stephen Anderson, president of the Washington Chapter of the ACEP warned in the press release that the Medicaid reductions could affect 19 other states.

For more information:
- read the amednews article
- read the press release

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