- Jan 2010
Doctors Sue Over ER Limits in Washington State
By OLIVIA KATRANDJIAN
Oct. 1, 2011
The American College of Emergency Physicians is suing the state of Washington in an effort to overturn the decision that low-income Medicaid patients will be limited to three non-emergency visits to the emergency room each year, which goes into effect today.
The suit seeks to get rid of the limit, which it says puts patients at risk.
The limit, which was created to reduce costs in emergency rooms, comes with a new list of 700 non-emergency symptoms, including difficulty breathing, dizziness, early-pregnancy hemorrhage, gall stones, abdominal pains and chest pains not related to a heart attack.
Patients with any of the 700 symptoms are urged to visit the regular doctor's office instead of the emergency room.
But doctors say patients may not be able to tell if their symptoms are indicative of an emergency.
For example, if a child burns himself on the stove, a parent may not know the difference between first, second and third degree burns.
"The ACEP is opposing the limit primarily because of the list of diagnoses that the state is proposing to be non-emergencies, like chest pains and heart arrhythmias and dysrhythmias, which can result in sudden death, sudden blindness, and hemorrhages during miscarriage," ACEP Washington Chapter president Steve Anderson said. "Their proposal is dangerous. It's almost funny it's so scary they would have them on the list.
(snip ... )
"There is a national legislation called the Prudent Lay Person Law, which says that your average Joe, if he has what he thinks is an emergency, is entitled to go to the ER, be evaluated and treated for it, and his insurance company can't retrospectively deny it," Anderson said. "That's in place to protect everybody. Not just Medicaid patients -- everybody. Our concern is that the health care authority said that doesn't apply to our clients. We're terrified that other places in the country will feel that it doesn't apply to their clients and constituents as well."
more: Doctors Sue Over ER Limits in Washington State - ABC News
Limit non-emergency ER visits annually - good idea or bad idea? Are the docs right about the list of non-emergency symptoms being too broad?