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Decision Package
Department of Medical Assistance Services (602)
Request Title 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.

Funding Summary
Object Type FY 2014 FY 2015  
General Fund Dollars $430,000 $430,000  
Nongeneral Fund Dollars $430,000 $430,000  
General Fund Positions 0.00 0.00  
Nongeneral Positions 0.00 0.00  
General Fund Transfers $0 $0  
General Fund Revenue $0 $0  
Layoffs $0 $0  
Additions to Balance $0 $0  
Funding Details
By Program Program Code Program Title FY 2014 FY 2015
  456 Medicaid Program Services $860,000 $860,000
By Fund Fund Code Fund Title FY 2014 FY 2015
  0100 General Fund $430,000 $430,000
  1000 Federal Trust $430,000 $430,000
Authorized Position Details
By Program Program Code Program Title FY 2014 FY 2015


p3_opview - Official Enacted Budget View Operating Bullet Details - 06-03-2025 20:41:06