We ask that DMAS temporarily halt implementation July 1st to comply with
the prudent layperson standard and ensure equal access to healthcare for all
Virginians.

The fact is, Emergency Departments are bound by both duty and law (EMTALA) to evaluate and treat any patient who presents to the department for care.  The departments and physicians and administrators cannot control which patients arrive, nor what conditions they arrive with. 

Patients may arrive with chest pain, headaches, abdominal pain, vomiting, etc etc.  Many of these conditions will be benign.  For 99% of headaches, nothing dangerous is going on.  But wouldn't you want the doctor to be willing, able, and available to correctly identify and treat the 1% of headaches that are dangerous (meningitis, subarachnoid hemorrhage, etc)??  Of course you would.  Wouldn't you want the equipment available?  The wait time to be adequately short to be seen in a timely fashion?  Nurses available?  For those resources to be available 24/7, they have to be paid for not just at the rare moment they are needed by a patient with a head bleed, but by all of the other patients who might have needed the resources but turned out not to.

It is completely unfair to all parties (patients and hospitals/EDs) to pay only $15 based on a final diagnosis that is deemed non-emergent.  Patients do not present at the triage desk with heart attacks.  They present with "chest pain" or "nausea", and it is up to astute, reasonably paid doctors to figure out who has a heart attack, and who doesn't.

DMAS policies like this are extremely short-sighted and will cut costs in the wrong way.  A better way would be to spend money on free health clinics where patients can get generic medication refills, health advice, and simple urgent care appointments.