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Washington To Limit Medicaid Emergency Room Visits
khq.com ^ | September 26, 2011

Posted on 10/02/2011 6:25:01 AM PDT by ilovesarah2012

OLYMPIA, Wash. (AP) - Washington state is preparing to limit Medicaid coverage of emergency room visits for non-emergency care.

State officials have notified clients that they will get coverage for only three of those visits each year starting Saturday. Additional visits will not be covered, and patients may be billed for that care.

(Excerpt) Read more at khq.com ...


TOPICS: Culture/Society; Government; News/Current Events; US: Washington
KEYWORDS: healthcare; obamacare
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1 posted on 10/02/2011 6:25:03 AM PDT by ilovesarah2012
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To: ilovesarah2012

And so it begins.


2 posted on 10/02/2011 6:26:16 AM PDT by dearolddad
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To: ilovesarah2012

too many use the emergency room for the doctor’s office


3 posted on 10/02/2011 6:26:27 AM PDT by yldstrk (My heroes have always been cowboys)
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To: ilovesarah2012

Waste of money to pay postage to mail a bill. They aren’t going to pay anyway. This is just going to hasten the bankrupcy of more hospitals.

And why should ANY non-emergency visits be covered?


4 posted on 10/02/2011 6:30:35 AM PDT by PAR35
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To: ilovesarah2012
Additional visits will not be covered, and patients may be billed for that care.

Dubious.

First, medical facilities cannot/will not deny service, emergency or otherwise. The resulting lawsuits would bankrupt them.

Second, patients may be billed, but being Medicaid-eligible indicates their resources are limited. Thus, the patients could refuse to pay. So, who makes up the difference? Taxpayers via subsidies to pay for the uncollected amounts.

==

This is one of those 'looks good on paper' proposals that, ultimately, will not solve anything.
5 posted on 10/02/2011 6:30:40 AM PDT by TomGuy
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To: yldstrk

You are absolutely right about that! I have worked ER’s in several states, and in every one, we were bogged down with non-emergency patients who we had to see regardless..........Fear of litigation ran deep.


6 posted on 10/02/2011 6:30:57 AM PDT by basil (It's time to rid the country of "gun free zones" aka "Killing Fields")
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To: yldstrk

In many areas there is no none emergency medical care available on weekends and after 5 PM. If the government
wants to deal with something deal with this obvious flaw!


7 posted on 10/02/2011 6:31:08 AM PDT by Average Al (Forbidden fruit leads to many jams.)
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To: Average Al

none = non


8 posted on 10/02/2011 6:31:42 AM PDT by Average Al (Forbidden fruit leads to many jams.)
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To: dearolddad
Thanks to EMTALA, you'll get treated if you show up at an ER. But if you show up with a toothache, which I saw a Medicaid recipient do in my neck of the woods a few months ago, why should taxpayers be on the hook for that?
9 posted on 10/02/2011 6:31:55 AM PDT by mewzilla (Forget a third party. We need a second one.)
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To: ilovesarah2012

Bill all you want, they won’t pay it. If they are illegal, or on welfare, or unemployed, there’s not much that can be done.


10 posted on 10/02/2011 6:33:49 AM PDT by A_perfect_lady (Islam is as Islam does.)
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To: PAR35
Who determines what an emergency is? Chest pain - indigestion or heart attack? Sore throat and neck pain - flu or meningitis? Severe headache - kids driving you crazy or aneurysm?
11 posted on 10/02/2011 6:36:08 AM PDT by ilovesarah2012
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To: yldstrk
As an RN Case Manager for a large hospital system, and already watching the Medicaid debacle, all it will do is move the cost to the hospital system. They will still come, it's just the hospital won't get paid. Just because Medicaid won't pay for their visit in no way means the patient will. Remember, to qualify for medicaid means you do not have any money. So the state is just transferring the cost to the hospital, already drowning in medicaid patients.

To fix it, the hospitals need to set up triage nurses at the door. Do not let these people register or make it to the waiting room. If the problem is determined to be non-emergent, call their MD and make an appointment for them for when the MD can see them and send them on the way. Before they get in the hospital to even sit down.

Our hospital will receive 32 million dollars less this year due to Medicaid cuts. We will still have to provide the care, but we just won't get paid. These Medicaid/medicare cuts in no way stop these people from receiving care. It stops hospitals and doctors from getting paid for care they provide as stipulated by the law and medical ethics.

12 posted on 10/02/2011 6:38:16 AM PDT by lynn4303
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To: ilovesarah2012

Isn’t it interesting that a northern, liberal, supposedly more “enlightened” state would attempt this!?


13 posted on 10/02/2011 6:38:31 AM PDT by mtrott
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To: mewzilla

Why should taxpayers be on the hook for a ten year war? I hate paying for a losing battle. I much rather pay for someone’s health than a soldier’s death. I also don’t like paying for aid to Pakistan or the Palestinians. We don’t have much say in where our tax money goes.


14 posted on 10/02/2011 6:39:07 AM PDT by ilovesarah2012
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To: lynn4303

That is why doctors are suing - they want to get paid.


15 posted on 10/02/2011 6:40:53 AM PDT by ilovesarah2012
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To: ilovesarah2012; All

Many Medicaid recipients use the ER for their family doctor because Medicaid pays for the ER but not office visits. Down in my part of Texas, one hospital put up a sign: “If your illness is not deemed an Emergency, you must pay a $50 charge before being seen by a physician.” That cleaned out the Emergency Room.


16 posted on 10/02/2011 6:41:35 AM PDT by no dems (No matter who it might be, when I find out a person is a Democrat, I lose respect for them.)
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To: dearolddad

So what if they will be billed. They aren’t going to pay. They would as soon owe $600 for a emergency room visit as $100 for an office visit.


17 posted on 10/02/2011 6:41:42 AM PDT by Blood of Tyrants (Islam is the religion of Satan and Mohammed was his minion.)
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To: yldstrk

It’s not their money. What do they care?


18 posted on 10/02/2011 6:42:48 AM PDT by Blood of Tyrants (Islam is the religion of Satan and Mohammed was his minion.)
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To: ilovesarah2012

A couple years ago there was a story around here about people that were on medicaid using the emergency room hundreds of times.

For stuff like a stubbed toe.

None of these people paid anything for their visit.


19 posted on 10/02/2011 6:42:49 AM PDT by dforest
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To: lynn4303

You know what? After seeing bills for $12 for a bandaid, boo hoo to the hospital


20 posted on 10/02/2011 6:43:30 AM PDT by yldstrk (My heroes have always been cowboys)
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To: ilovesarah2012
Uh...tell me one more time how 'obamacare' makes medical care better....

threedocs
21 posted on 10/02/2011 6:43:46 AM PDT by FrankR (What you resist...PERSISTS!)
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To: Blood of Tyrants

That’s the reasoning alright


22 posted on 10/02/2011 6:44:22 AM PDT by yldstrk (My heroes have always been cowboys)
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To: no dems

Yep, that will do it. People always overuse what they don’t have to pay for.


23 posted on 10/02/2011 6:44:30 AM PDT by dforest
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To: ilovesarah2012

I don’t object to this, this is medicaid. Some have no choice but there are plenty of others on medicaid that have gamed the system and shouldn’t be on it anyway.


24 posted on 10/02/2011 6:44:30 AM PDT by shield ((Rev 2:9 Woe unto those who say they are Judahites and are not, but are of the syna GOG ue of Satan.)
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To: TomGuy
First, medical facilities cannot/will not deny service, emergency or otherwise. The resulting lawsuits would bankrupt them.

Actually, turning them away is a Federal crime.

Lawsuits are a minor problem, compared to EMTALA.

25 posted on 10/02/2011 6:44:49 AM PDT by Jim Noble (To live peacefully with credit-based consumption and fiat money, men would have to be angels.)
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To: ilovesarah2012

Took my mother in law to a hospital emergency room in Allentown,Pa. last Feb. I sat there from 5:00 PM til midnight & saw a constant parade of whole families that did not speak english go in for treatment of colds.(alleged colds) You hear about this stuff but it is a shock when you see it. There were no questions asked they just let them in. We pay for this crap. It needs to be changed as we all know.


26 posted on 10/02/2011 6:45:56 AM PDT by certrtwngnut
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To: ilovesarah2012

Pay for your generosity with your own money. Not mine :-)


27 posted on 10/02/2011 6:46:31 AM PDT by mewzilla (Forget a third party. We need a second one.)
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To: no dems

What services and medical costs does Medicaid cover?
Medicaid will pay for the services listed below. Some people are required to pay copayments for starred(*) services.
COVERED SERVICES:
ç Doctor visits/services *
ç Hospital services (Limits apply) *
ç Lab and X-ray
ç Dental care (Limits apply) *
ç Eye care (Limits apply) *
ç Prescribed Drugs

http://www.nd.gov/dhs/info/pubs/docs/dn-555-medicaid-brochure-1003.pdf


28 posted on 10/02/2011 6:48:47 AM PDT by ilovesarah2012
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To: certrtwngnut

If more folks had skin in the game, they’d be far less likely to abuse the system. Our health insurance, for example, has a low three figure co-pay for ER visits. Even if we were inclined to abuse the ER, that co-pay would ensure that we don’t.


29 posted on 10/02/2011 6:49:25 AM PDT by mewzilla (Forget a third party. We need a second one.)
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To: mewzilla

That’s my point. We don’t get to decide how our tax money is spent.


30 posted on 10/02/2011 6:49:53 AM PDT by ilovesarah2012
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To: ilovesarah2012

***Who determines what an emergency is?***

Triage.

Since hospitals will lose money with this limitation - perhaps they will organize ‘out-patient’ clinics for minor complaints, rather than clog up the ER beds & facilities.


31 posted on 10/02/2011 6:50:18 AM PDT by sodpoodle (God is ignoring me - because He is watching you.)
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To: ilovesarah2012

Liberals will shelve this by asserting discrimination against ILLEGALS.


32 posted on 10/02/2011 6:50:45 AM PDT by G Larry (I dream of a day when a man is judged by the content of his character)
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To: ilovesarah2012

What percentage of your county’s budget goes to meet its Medicaid obligation?


33 posted on 10/02/2011 6:51:49 AM PDT by mewzilla (Forget a third party. We need a second one.)
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To: certrtwngnut

I get medical care at our local health department. Usually I am one of maybe three non-Spanish patients. Like being in a foreign country. Are they here legally? Who knows?


34 posted on 10/02/2011 6:52:12 AM PDT by ilovesarah2012
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To: ilovesarah2012
A person on Medicaid will take an ambulance to the ER for a sprained ankle rather than cough up $10 for a cab ride. Medicaid needs reasonable co-payments attached to it to avoid this crap.
35 posted on 10/02/2011 6:52:12 AM PDT by Shqipo (I am AttackWatch parolee #1,237. I am breaking my parole once more.)
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To: Shqipo

You obviously haven’t ridden in a cab lately!


36 posted on 10/02/2011 6:53:19 AM PDT by ilovesarah2012
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To: ilovesarah2012

“”State officials have notified clients that they will get coverage for only three of those visits each year starting Saturday. Additional visits will not be covered, and patients may be billed for that care.””


The only reasons I can imagine a person would need to visit the emergency room more than three times per year is:

1. Overdosing on illegal drugs.
2. Bullet or knife wounds from illegal actions.

It seems Washington needs to toss some Medicaid patients into the slammer.


37 posted on 10/02/2011 6:54:07 AM PDT by Presbyterian Reporter
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To: ilovesarah2012
“That is why doctors are suing - they want to get paid.”

My Father-in-Law is a Dentist in WA State. His fees and services are highly dictated by the State and Insurance companies and it's nearly driving him out of business. He has not been able to raise his fees enough to keep up with his cost of running his office. He has said that he always wanted to have his own business, but he feels like he is now an employee of the State.

38 posted on 10/02/2011 6:56:22 AM PDT by NavyCanDo
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To: Presbyterian Reporter

That would be interesting. If you want ER care, you have to first pass a drug test. Would probably clear out the ER real quick.


39 posted on 10/02/2011 6:56:32 AM PDT by ilovesarah2012
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To: ilovesarah2012
And the bill for the ambulance to you and me is between $400 to $800 dollars.
40 posted on 10/02/2011 6:56:49 AM PDT by Shqipo (I am AttackWatch parolee #1,237. I am breaking my parole once more.)
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To: lynn4303

***To fix it, the hospitals need to set up triage nurses at the door. Do not let these people register or make it to the waiting room. If the problem is determined to be non-emergent, call their MD and make an appointment for them for when the MD can see them and send them on the way. Before they get in the hospital to even sit down.***

I hope you have presented your brilliant idea to the Hospital trustees;) Common sense and practical. If the patients don’t already have an MD - the hospital should have an ‘outpatient’ area staffed with PAs and rotating GPs.

The upswing in “urgent care centers’ is clearly the best way to solve Emergency Room abuse.


41 posted on 10/02/2011 6:57:09 AM PDT by sodpoodle (God is ignoring me - because He is watching you.)
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To: no dems
“If your illness is not deemed an Emergency, you must pay a $50 charge before being seen by a physician.” That cleaned out the Emergency Room.
There it is, and that's the policy that should be implemented nationwide.
I'm so sick of the gaming of the system by the "underrepresented" in this country I could .... whatever.
42 posted on 10/02/2011 6:57:28 AM PDT by oh8eleven (RVN '67-'68)
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To: lynn4303
About 20 some-odd years ago I was at a financial low point, unemployed (read, working off the books) and had to go to a NYC ER at about 12:30 AM. I had contracted a severe and aggressive infection that resulted in what I was told was “blood poisoning”. I was jumped over many that were in line and was treated immediately. Since I was basically broke, when the bills came they went to the circular file...un-opened.
A couple of years later, now on my feet financially, I returned to the city hospital with the intent to square things up. I was told that doing so would cause so much time and trouble that they were just not interested. They told me to just forget about it.
43 posted on 10/02/2011 6:57:53 AM PDT by Roccus (Obama & Holder LLP, Procurers of fine arms to the most discerning drug lords (202) 456-1414)
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To: NavyCanDo

I imagine it will get worse once Obamacare really kicks in.

IBD poll: 45% of doctors would consider quitting under Obamacare

http://michellemalkin.com/2009/09/15/ibd-poll-45-of-doctors-would-consider-quitting-under-obamacare/


44 posted on 10/02/2011 6:58:36 AM PDT by ilovesarah2012
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To: NavyCanDo

Tell him to move to Texas.


45 posted on 10/02/2011 6:59:01 AM PDT by shield ((Rev 2:9 Woe unto those who say they are Judahites and are not, but are of the syna GOG ue of Satan.)
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To: TomGuy
Second, patients may be billed, but being Medicaid-eligible indicates their resources are limited. Thus, the patients could refuse to pay. So, who makes up the difference? Taxpayers via subsidies to pay for the uncollected amounts.

For those who are on welfare, instead of billing, simply deduct the amount from their next month's welfare or food stamp allocation. But that would make to much sense and would be too effective, so the lawyers would bar that.

46 posted on 10/02/2011 7:00:31 AM PDT by PapaBear3625 (When you've only heard lies your entire life, the truth sounds insane.)
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To: yldstrk
too many use the emergency room for the doctor’s office family room

Bigger TV, nicer chairs, vending machines right down the hall, someone to pick up after the kids when they toss their trash on the floor. I recently saw a family of gypsys that had pretty much overtaken every waiting room on the entire floor. They were there for days while one of their elders was being treated.

They had a tableful of grocerybags, and a big crockpot set up in one of the waiting rooms. My family had to go to another floor of the hospital to find a quiet place to rest.

47 posted on 10/02/2011 7:00:40 AM PDT by digger48
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To: Jim Noble; TomGuy

“Actually, turning them away is a Federal crime.”

“Lawsuits are a minor problem, compared to EMTALA.”

What follows is a serious proposition (not sarcasm or a joke):

Why not “subscription-only” hospitals WITHOUT “emergency rooms”?

That is, a hospital that is purpose-built to serve ONLY those who are pre-enrolled in medical plans, either through third-party insurers or perhaps through a “direct-paid” subscription from individuals/families (kind of like “concierge” doctors)?

Like the line from “Field of Dreams”:
“If you built it, they will come.”

Turn this around:
“If you DON’T build it, they WON’T come.”

That is to say, provide extensive medical services withOUT handling emergencies, and they will have no choice but to go somewhere else.

What does the law say about that?

Just wonderin’....


48 posted on 10/02/2011 7:04:45 AM PDT by Grumplestiltskin (I may look new, but it's only deja vu!)
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To: sodpoodle

A CEO at a New England hospital stated a number of years ago that “85% of the trips to the Emergency Room really weren’t emergencies.” I’m not sure whether he was talking about his specific hospital or some sort of regional average, though...


49 posted on 10/02/2011 7:04:45 AM PDT by who knows what evil? (G-d saved more animals than people on the ark...www.siameserescue.org.)
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To: Average Al
In many areas there is no none emergency medical care available on weekends and after 5 PM. If the government wants to deal with something deal with this obvious flaw!

About two months ago on a Saturday morning my daughter and son in law were told by the pediatrician to bring my granddaughter to the ER. Unbeknownst to the doctor and my daughter the hours for the ER on Saturday and Sunday had been changed to noon to 5 only. No doctors or nurses available. All kinds of people there bleeding, moaning, one kid had blood dripping from his head. They were all told to either sit there til noon or come back at noon. None of them were seen or registered to be seen. Hospital security was there to make sure people didn't complain too loudly. My granddaughter ended up being taken to another ER on the other side of town. They were in and out in three hours.

50 posted on 10/02/2011 7:06:07 AM PDT by rockabyebaby (We are sooooooooooooooooooooooooooooooooo screwed!)
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