The resources on this page are designed to assist chapters in advocating for adequate and fair reimbursement policies at the state level. Case studies offer models of effective strategies and tactics employed by other chapters in addressing critical reimbursement issues. Additionally, sample legislation, talking points and other resources are provided to equip chapters with helpful tools in ensuring that managed care companies provide equitable treatment to emergency physicians that do not participate in their networks.

Private Payor Resources 

Fair Payment/Balance Billing:

• New Toolkit for Chapters Dealing with Out-of-Network Payment and Balance Billing Legislation

Assignment of Benefits:

• Case Study
• Talking Points
• Sample Legislation

Medicaid Resources

• Medicaid ED Copayments: Effects on Access to Emergency Care and the Practice of Emergency Medicine - An Information Paper
• Medicaid Model Action Plan for Chapters
• Ensuring Adequate Medicaid Reimbursement: The Michigan Experience
• Rhode Island Chapter Increases Reimbursement Despite State’s Fiscal Crisis
• NJ Medicaid Reimbursement: Working with State Policy Makers
• Florida ACEP's Successful Campaign to Increase Reimbursement
• Testimony - Ohio Commission to Reform Medicaid Public Hearing
• Talking Points - NJ Medicaid Copay Proposal
• Ohio Commission to Reform Medicaid Recommendations - Condensed List
• Kentucky Chapter President Letter to the Editor on ED Copay Proposal
• Maryland Talking Points with Rep. Hurson - National Medicaid Reforms - Issues with Emergency Medicine
• Talking Points for Medicaid Reform and Emergency Care

CMS/HHS Support of Prudent Layperson Requirement for Medicaid:

• 2013 CMS Draft Rule-Nonemergency Copays (1-22-13) (pages 67 & 11) 
• 2013 CMS Final Rule-Nonemergency Copays (7-15-13) (pages 120 & 152) 
• 2003 CMS Letter to State Medicaid Directors
• 2000 CMS Letter to State Medicaid Directors
• 1998 HHS Letter to State Medicaid Directors
• 1998 HHS Letter to ACEP