- State Medicaid to quit paying for ER visits deemed unnecessary, By Carol M. Ostrom, February 7, 2012, Seattle Times: “Intent on cutting state budget health-care costs, Medicaid officials say the program 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. The rules – arguably more drastic than an earlier proposal to limit Medicaid patients to three visits per year for nonemergency conditions – would block payment for ER visits for about 500 different conditions. They would apply to all adults and children on Medicaid, with no exceptions, such as someone being brought in by ambulance or from a nursing home, or when patients have neurological symptoms or unstable vital signs. The new rules are to begin April 1, but a statewide group of emergency doctors, backed by the Washington State Medical Association and the Washington State Hospital Association, are pressing lawmakers to stop the plan, arguing it would shift costs to hospitals and ER doctors and deny care to people with real emergencies…”
- Medicaid may stop covering visits to ER later deemed ‘unnecessary’, By Jordan Schrader, February 8, 2012, Tacoma News Tribune: “Medicaid soon might stop covering emergency-room treatment that state officials decide afterward was ‘not medically necessary.’ A state Health Care Authority rule putting a three-visit limit on unnecessary ER use by poor patients was blocked in court on procedural grounds. The agency has replaced it with a new policy planned to take effect April 1 that would reduce the number of conditions deemed non-emergencies but would forbid even a single unnecessary visit. The doctors and hospitals who sued over the old rule blasted the new plan Tuesday, saying it would leave it up to a ‘faceless bureaucrat’ to decide what’s an emergency. They weren’t ready to say they’ll go to court again over it…”
Poverty-related issues in the news, from the Institute for Research on Poverty