Eliminate emergency room payment reduction for physicians
Biennium
2014-2016
Budget Round
Initial Bill
Category
Operational efficiencies and service reductions
Region
Multiple Regions
Description
Eliminates the policy of reducing physician fees for non-emergency visits in hospitals. Originally, this policy was initiated in the early 1990s to incentivize emergency rooms (ERs) to triage and divert non-emergency patients to more appropriate and cost-effective settings. However, after the federal Emergency Medical Treatment and Active Labor Act (EMTALA) was implemented several years later, ERs no longer had any choice but to treat any patient that comes through the door, emergency or not. However, the fee reduction policy for non-emergency claims has continued to this day. The reduction for the hospital claim of an ER visit is currently being eliminated through the adoption of a new payment methodology. This action addresses the reduction for the physician ER claim.