When I first saw that this was being proposed I was shocked.  I am even more shocked that it has been passed and is soon to be implemented.  I understand that your goal is to reduce ER visits and to reduce the money being paid out by medicaid for these visits but this is definitely not the way to do it.  

Just because medicaid is essentially not going to pay for any ER visit since the list is so extensive, does not mean that patients with medicaid will stop coming to the ER.  They will continue to come.  Since medicaid pays so little most primary care and specialist do not accept medicaid leaving people with medicaid nowhere to get care.  I frequently see patients in the ER with medicaid but cannot find any providers to accept it, leaving them nowhere else to go but the ER.  Until the medicaid program is improved and can somehow increase the access to care so that patients do not have to come to the ER, you should not penalize the ER for seeing patients they are required to see.  

I have read through the list of diagnoses that will not be covered and it is ridiculous to think that a lay person will be able to distinguish what is emergent or not.  Although it most likely will not matter to them, they will still come to the ER because medicaid not paying does not affect them only the hospital and provider.  Some of the diagnoses on the list are things people would need to be admitted to the hospital for.  For instance E10.10 Type 1 diabetes mellitus with ketoacidosis without coma.  This would still require the patient to be admitted to an ICU with an insulin drip.  How you can deny payment for this is unconscionable.  I urge to reconsider implementing this policy.  

Implementing this will have severe consequences for many ER's who will still be seeing medicaid patients but not being paid.  For many ER's it will mean reduced staffing and increased wait times which could have dire consequences for some.  

Again please reconsider implementing this policy as it will be harmful to all Virginians.