ACEP Fights State Medicaid Cuts in WA

Cheryl Clark, October 17, 2011

The state of Washington's new policy of re-classifying 700 potentially life-threatening patient conditions as non-emergent, for which it will not pay, will have "potentially devastating consequences" for patients, families, and for the long-term health of the Medicaid system, the state chapter of the American College of Emergency Physicians said in a statement Sunday.

The chapter has filed a request for a temporary injunction with Superior Court in Thurston County and has an alternative plan to achieve the $72 million in annual savings that the state's new policy aims for.

According toWA- ACEP, the impacts of the new state policy include:

Sicker Patients, More Admissions

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Patients who have exceeded their three visit limit that need emergent care (e.g. asthma exacerbations) will wait for care in a broken system that will now not guarantee them access. Their emergency department visits that would have been 'unnecessary' now will be inpatient 'necessary' admissions for exponentially higher costs.

Costly Litigation

Expensive litigation against the state for implementing a plan that is on its face in violation of federal and state law will occur if we fail to create a better solution. The prudent layperson standard in the state and now federal law under (Patient Protection and Affordable Care Act) prohibits this type of retrospective denial.


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