Undermines EMTALA, Violates Prudent Layperson Standard, and Promotes Health Disparities
Patients Are Negatively Impacted
This program encourages patients to self-diagnose and determine whether an emergency condition exists before being seen by a medical professional. It is necessary for CMS guidance to mandate that state Medicaid programs and MCOs reimbursement physicians and hospitals for delivering emergency care based on the patient’s presenting symptoms, NOT a diagnosis list.
Emergency Physicians serve as the healthcare safety net when Medicaid recipients don’t have access to primary care and are exposed to public health threats. These patients would continue to be disproportionately impacted as critical-access hospitals lose Medicaid funding essential to their survival.
Health Equity
Underrepresented populations lack consistent access to proper healthcare and as a result, suffer poor medical outcomes. The COVID-19 pandemic and its emergence in the United States and Virginia has further exposed this problem. A data set from Johns Hopkins University has found that African Americans are three times more likely to contract COVID-19 and six times more likely to succumb to the disease than any other racial demographics.
Minorities in the United States have disproportionate rates of co-morbidities that increase risk factors for COVID-19 (obesity, lung disease, diabetes, hypertension, and other immune-compromising diseases). Many of these conditions are on the “preventable” diagnosis list.
These dramatically reduced payments to providers will result in fewer physicians in the Emergency Departments across Virginia. This will significantly increase wait times, especially in urban and rural hospitals, which have a higher percentage of Medicaid patients.
The Impact on the Physician Community
By federal law, Emergency departments must treat all patients regardless of insurance status or ability to pay. Virginia’s actions will decimate emergency staff and their hospitals ability to provide quality access to care.
There is a moral principal that Emergency Physicians believe and preach: All people deserve care.
