Virginia Regulatory Town Hall
Agency
Department of Medical Assistance Services
 
Board
Board of Medical Assistance Services
 
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6/15/20  9:15 am
Commenter: Glen Hookey, MD

Protect patients, not insurance companies
 

Protect patients and the doctors that treat them, not insurance companies.

 

Patients should never be put in a position where they are expected to self-diagnose and determine whether an emergency condition exists before being seen by a medical professional. This is called the “prudent layperson” standard and it requires care to be provided if the patient believes they are having an emergency. We believe that CMS guidance obligates state Medicaid programs and managed care organizations (MCOs) to reimburse doctors and hospitals for the delivery of such emergency medical care based on presenting symptoms, not using a diagnosis list.

 

Additionally, this would disproportionately affect minority patients.  

CommentID: 80285