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KY Letter to the Editor on Copays from Ray Hart

November 18, 2005
Louisville Courier-Journal

Changes in Medicaid program

An Oct. 27 article, "Medicaid to curb ER payments," outlined the state's plan to implement changes in the Medicaid program, including the decision to stop paying for "non-emergency" visits to hospital emergency departments. While this decision may appear sensible on the surface, it ignores the complex realities related to this issue.

First, the perception that there is a significant amount of "non-emergency" care provided in emergency departments is incorrect. The overwhelming majority of emergency care provided is for the treatment of emergency medical conditions. Additionally, federal law mandates that all patients who seek care at an emergency department are provided a medical screening to determine if an emergency condition exists. The vast majority of Medicaid patients only come to the emergency department when they believe an emergency medical condition might exist.

There are more effective ways for the state to address this issue. For example, ensuring an adequate number of primary care physicians and off-hour providers who accept Medicaid patients will help keep patients from seeking care in the emergency department.

We want to work with the state to explore real solutions to the Medicaid problem, and we urge the state to reconsider this ill-conceived effort.

RAYMOND G. HART, M.D.
President
Kentucky Chapter of the American
College of Emergency Physicians
Louisville 40202

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