Emergency physicians and hospitals cannot control when and why patients seek care, nor can they turn anyone away. We must continue to improve access to primary care and help prevent Medicaid patients from getting sicker, but that goal is not achieved with this policy. Instead, we should be improving coordination of care at all levels, including the Medicaid Managed Care Organizations. Denying payment for care that was rightly provided in the ER is often the result of the Medicaid MCO failing to manage care of their enrollees. Strenghtening Medicaid Managed Care Organizations should be the objective. We should not be denying payment for emergency treatment based on arbitrary diagnosis codes. Thank you.