2013 Session

Budget Amendments - SB800 (Committee Approved)

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Intent to Eliminate Emergency Room Claims Reduction (language only)

Item 307 #4s

Item 307 #4s

Health And Human Resources
Medical Assistance Services, Department of

Page 280, after line 14, insert:
"JJJJ.  It is the intent of the General Assembly to eliminate the emergency room (ER) pend program as it relates to reducing physician fees.  Prior to elimination, the Department of Medical Assistance Services shall review the current policy of pending level 3 emergency room physician reimbursement claims to determine if it is an effective cost-containment policy and an efficient use of state resources to administer the program.  The department shall also review the extent to which Medicaid managed care organizations have implemented similar policies.  Finally, the review shall assess the cost and implications of eliminating this policy.  The department shall report its findings to the Chairmen of the Senate Finance and House Appropriations Committees no later than October 15, 2013."

(This amendment adds language to review the current policy of pending emergency room (ER) reimbursement claims to determine whether a lower reimbursement should be made to ER physicians based on the results of the medical encounter. Budget language requires a report on the effectiveness of this tool, the extent this tool is used by other states and the implications of eliminating the policy.)